* * * MY EVACUATION PLAN * * *

I will evacuate from my home only if instructed to do so by an
emergency worker or by a radio broadcast or by calling 211.

I put copies: 0 on my refrigerator 0 in my car

0 in my evacuation Go Bag 0 with my Support Team

Name Date

Home address:

Home phone:

Cell phone:

Where will I go?

I have arranged to stay with this friend for three days:

Name:

Email:

Street, City, State:

Home phone:

Cell phone:

This is my backup person I can stay with for three days:

Name:

Email:

Street, City, State:

Home phone:

Cell phone:

Work phone:

How will I go?

Name:

Email:

Street, City, State:

Home phone:

Cell phone:

Work phone:

I/we have practiced my Evacuation Route and a Backup Route. Where will my animals go?
’ I have a service animal and they will stay with me at the shelter.
’ My animals will come with my to my friend’s or to my hotel.
’ My non-service dogs and cats will evacuate with me and be sheltered by emergency workers near the shelter.
’ I have arranged for my animals to stay with:

Name Email

Home phone______________________ Cell phone
What will I take?

’ My Evacuation Go Bag (See “Evacuation Go Bag” handout)

’ My medications and supplies

’ My Emergency Information sheet and important papers

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Before I go, I will:

’ Call my Primary Contact Person.

’ Notify my neighbors.

’ Make arrangements for all of my animals and pets.

’ Lock my doors.

’ Leave a note or a copy of My Evacuation Plan on my kitchen counter describing where I am going and how to contact me.

’ Shut off the electricity and gas if I am instructed to do so by an emergency worker or by a radio broadcast.

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