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This form is intended for individuals at UTHSC-H who require assistance during evacuations in case of emergencies. It allows users to request temporary or ongoing assistance and provides a means to communicate their needs to the Environmental Health & Safety team.
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How to fill out emergency evacuation assistance request

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How to fill out emergency evacuation assistance request

01
Obtain the emergency evacuation assistance request form from your local emergency management office or website.
02
Fill in your personal information, including your name, address, and contact details.
03
Indicate the reason for the request, detailing any medical or mobility issues that may require assistance.
04
Specify any special needs, such as wheelchair accessibility or medical equipment.
05
Provide information about your current situation and any imminent threats.
06
Include the names and contact information of any family members or caregivers who will assist you.
07
Review the form for accuracy and completeness.
08
Submit the form to the relevant emergency management office or agency as instructed.

Who needs emergency evacuation assistance request?

01
Individuals with mobility impairments who cannot evacuate without assistance.
02
People with medical conditions requiring special care during evacuation.
03
Elderly individuals who need help moving in an emergency.
04
Families with young children who may require additional support.
05
Anyone living in high-risk areas facing imminent threats, such as natural disasters.

What is Emergency Evacuation Assistance Request Form?

The Emergency Evacuation Assistance Request is a fillable form in MS Word extension required to be submitted to the relevant address in order to provide specific info. It must be completed and signed, which can be done manually in hard copy, or via a particular solution like PDFfiller. This tool helps to fill out any PDF or Word document directly from your browser (no software requred), customize it depending on your requirements and put a legally-binding e-signature. Once after completion, the user can easily send the Emergency Evacuation Assistance Request to the appropriate person, or multiple ones via email or fax. The editable template is printable too because of PDFfiller feature and options presented for printing out adjustment. Both in digital and physical appearance, your form will have a organized and professional outlook. You may also turn it into a template for later, there's no need to create a new file from the beginning. All that needed is to edit the ready document.

Emergency Evacuation Assistance Request template instructions

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How should you fill out the Emergency Evacuation Assistance Request template

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An emergency evacuation assistance request is a formal appeal made by individuals or organizations to seek help for evacuating during emergencies, such as natural disasters or other critical situations.
Individuals who are at risk during emergencies, such as residents in disaster-prone areas, and organizations that support vulnerable populations, are typically required to file an emergency evacuation assistance request.
To fill out an emergency evacuation assistance request, individuals should provide personal information, details about the emergency situation, the type of assistance needed, and any special considerations relevant to their circumstances.
The purpose of an emergency evacuation assistance request is to ensure that individuals in need receive timely help and resources during emergencies, facilitating their safe removal from danger.
The report must include personal identification details, nature of the emergency, specific assistance needed, location, and any medical or mobility requirements.
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