Use this form to list information about how to contact local emergency services. Make sure to update it at least once a year.
If you create your own emergency contacts form, include this information at the top:
- Program name
- Address
- Program phone number
- Communication lead’s contact information
Include contact information for:
- Medical or other emergency services
- Hospital or clinic
- Police
- Fire
- Mental health services
- Poison control
- Local emergency management agency
- Public health department
- Electric company
- Gas company
- Water company
- Waste disposal
- Insurance provider
- Off-site relocation point 1
- Off-site relocation point 2
Download Local Emergency Contacts Form
