Emergency Preparedness Plan

EMERGENCY PREPAREDNESS PLAN
Created For:
Date Updated:
TABLE OF CONTENTS
Table of Contents
Page 1
Concerns & Goals
Page 2
TOPICS
1. Food
Page
2. Water
Page
3. Communications
Page
4. Power
Page
5. Medical
Page
6. Hygiene & Sanitation
Page
7. Security
Page
8. Shelter
Page
9. Transportation
Page
10. Skills
Page
11. Self-Sustainability
Page
12. Community
Page
13. Documents & Resources
Page
o Important Paperwork
o Calendar
o Maps
o Resources
o Emergency Kit List
This free template was provided by Southern Oregon Survival
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914 SW 6 St., Grants Pass
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Our Concerns-what we are preparing for
Our Goals
People considered in this plan:
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FOOD SUPPLIES
Food supply duration:
Amount of people:
READINESS LEVEL 1-10
NOTES:
CANNED GOODS/PANTRY
QTY
HOW OFTEN
TOTAL NEEDED
IN STOCK
PRICE
DRIED BULK GOODS
QTY
HOW OFTEN
TOTAL NEEDED
TOTAL:
IN STOCK
PRICE
TOTAL:
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4
BAKING
QTY
HOW OFTEN
TOTAL NEEDED
IN STOCK
PRICE
FREEZE DRIED/DEHYDRATED
QTY
HOW OFTEN
TOTAL NEEDED
TOTAL:
IN STOCK
PRICE
DRINKS
QTY
HOW OFTEN
TOTAL NEEDED
TOTAL:
IN STOCK
PRICE
TOTAL NEEDED
TOTAL:
IN STOCK
PRICE
FARM ANIMALS/BIPRODUCTS
QTY
TOTAL:
HUNTING/TRAPPING/FISHING
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5
GARDEN
CHARITY/BARTER
QTY
TOTAL NEEDED
IN STOCK
PRICE
TOTAL:
FOOD GRAND TOTAL:
NOTES:
FOOD STORAGE & PRESERVATION
BULK DRIED FOODS
QTY
CANNING
QTY
LEFTOVER FOODS
QTY
SIZE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
TOTAL NEEDED
IN STOCK
PRICE
TOTAL NEEDED
IN STOCK
PRICE
FOOD STORAGE GRAND TOTAL:

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COOKING
NOTES:
COOKING SOURCES
SIZE
FUEL TYPE
TOTAL NEEDED
COOKING SUPPLIES
SIZE
FUEL TYPE
TOTAL NEEDED
IN STOCK
IN STOCK
PRICE
PRICE
COOKING GRAND TOTAL:
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WATER
Water supply duration:

NOTES:
Amount of people:
1.
2.
3.
4.
WATER NEEDS
GALLONS
HOW OFTEN
TOTAL NEEDED
WATER STORAGE
CAPACITY
LOCATION
REPLENISHABLE SOURCES
CAPACITY
LOCATION
WATER PURIFICATION
CAPACITY
FILTER AMOUNT
TOTAL NEEDED
IN STOCK
PRICE
IN STOCK
PRICE
TOTAL STORED
TOTAL NEEDED
CHARITY/BARTER
TOTAL:
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COMMUNICATIONS
NOTES:
In town meeting places:
Out of town meeting places:
Pick up locations:
ICE Contact Person #1

Name:
Home Phone:
Street:
Ham Radio Operator: Yes

Cell Phone:
City:
No
ICE Contact Person #2

Name:
Home Phone:
Street:
Ham Radio Operator: Yes

Cell Phone:
City:
No
HAM Radio Network

Name:
Call Sign:
Location:
Name:
Call Sign:
Location:
Name:
Call Sign:
Location:
Name:
Call Sign:
Location:
RADIO EQUIPMENT
TYPE
RADIO BANDS
TOTAL NEEDED
Call sign:
State:
Zip:
Call sign:
State:
IN STOCK
Zip:
PRICE
TOTAL:
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POWER
NOTES:
EMP Protection:
FUEL
TYPE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
POWER SUPPLIES
TYPE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
BATTERIES
TYPE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
TOTAL:
SELF-SUSTAINABLE POWER
SOLAR PANELS
TYPE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
SOLAR BATTERY PACKS
TYPE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
SOLAR Accessories
TYPE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
HYDRO
TYPE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
WIND
TYPE
SIZE
TOTAL NEEDED
IN STOCK
PRICE
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10
Complete one form per person
MEDICAL
NAME:
HEALTH INSURANCE PROVIDER:
COPAY:
NOTES:
PHONE:
POLICY NUMBER:
DOCTORS NAME:
ADDRESS:
NOTES:
PHONE:
DOCTORS NAME:
ADDRESS:
NOTES:
PHONE:
DENTAL INSURANCE PROVIDER:

COPAY:
PHONE:
POLICY NUMBER:
DENTISTS NAME:
ADDRESS:
NOTES:
PHONE:
HEALTH HISTORY:
SPECIAL NEEDS:
MEDICATIONS CURRENTLY TAKING:
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11
MEDICAL
NOTES:
MEDICAL KITS
SIZE
DURATION
TOTAL NEEDED
IN STOCK
PRICE
MEDICAL SUPPLIES
SIZE
DURATION
TOTAL NEEDED
IN STOCK
PRICE
ADULT ITEMS
SIZE
DURATION
TOTAL NEEDED
IN STOCK
PRICE
KID ITEMS
SIZE
DURATION
TOTAL NEEDED
IN STOCK
PRICE
PET MEDICATIONS
SIZE
DURATION
TOTAL NEEDED
IN STOCK
PRICE
VITAMINS
SIZE
DURATION
TOTAL NEEDED
IN STOCK
PRICE
PANDEMIC PREPARATIONS:
PSYCHOLOGY AND MENTAL PREPAREDNESS:
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12
HYGIENE & SANITATION
Supply duration:
Amount of people:
HYGIENE NOTES:
Keep fingernails cut short. Wash hands often using baby wipes first and then use water or hand sanitizer.
HYGIENE
QTY
HOW OFTEN
TOTAL NEEDED
QTY
HOW OFTEN
PRICE
SANITATION NOTES:
Keep all hazardous wastes away from water and food sources.
SANITATION
IN STOCK
TOTAL NEEDED
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IN STOCK
PRICE
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13
SECURITY
HOME /PROPERTY PROTECTION:
EARLY WARNING SYSTEMS:
MAP OF PROPERTY
NEIGHBORHOOD SECURITY:
SELF DEFENSE:
TRAINING:
TRAINING GOALS:
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14
SHELTER
NOTES:
LIGHTING
NOTES:
HEATING & COOLING
NOTES:
HOME HAZARDS
LOCATION
NOTES:
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15
SHELTER-IN-PLACE
NOTES:
BACK-UP SHELTER
Location
NOTES:
BUGGING OUT
Location
NOTES:
DRILLS
Fire
Earthqauake
Shelter-in-place
Bugging out
Lights out (2 hour)
Lights out (24 hour)
Security (break in)
DATE
DATE
DATE
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DATE
16
TRANSPORTATION
NOTES:
VEHICLES
MAKE
MODEL
YEAR
FUEL TYPE
IN STOCK
NOTES:
MAINTENANCE
NOTES:
TRAVELING
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17
SKILLS
NOTES:
NAME
CURRENT SKILL/TRADE
NOTES:
NAME
SKILL/TRADE GOALS
NOTES:
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18
NOTES:
SELF-SUSTAINABILITY
GARDENING
FARM ANIMALS
HAND TOOLS
DIY PROJECTS
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19
NOTES:
COMMUNITY
NEIGHBORHOOD PLANS:
NEIGHBOR CONTACT INFORMATION:
BARTERING:
CITY / COUNTY / STATE INFORMATION:
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20
IMPORTANT DOCUMENTS
Include copies of all valuable paperwork or documents:

Drivers licenses or picture IDs
Birth Certificates
Insurance Cards
Social Security Cards
Deed to your house
Sales contracts
Any other valuable form or document
(make sure you keep these in a secure location)
CALENDAR
Mark on your calendar important events pertaining to your preparedness plan.

Drills, checking supplies for expired items, upcoming classes or training, neighborhood group meetings, sales, etc.
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Emergency Preparedness Plan

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EMERGENCY PREPAREDNESS PLAN

Concerns & Goals

6. Hygiene & Sanitation

13. Documents & Resources

914 SW 6 St., Grants Pass

Our Concerns-what we are preparing for

People considered in this plan:

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

Food supply duration:

DRIED BULK GOODS

914 SW 6 St., Grants Pass

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

FOOD GRAND TOTAL:

FOOD STORAGE & PRESERVATION

READINESS LEVEL 1-10

BULK DRIED FOODS

FOOD STORAGE GRAND TOTAL:

914 SW 6 St., Grants Pass

READINESS LEVEL 1-10

COOKING GRAND TOTAL:

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

Water supply duration:

914 SW 6 St., Grants Pass

READINESS LEVEL 1-10

In town meeting places:

Out of town meeting places:

ICE Contact Person #1

Ham Radio Operator: Yes

ICE Contact Person #2

Ham Radio Operator: Yes

HAM Radio Network

914 SW 6 St., Grants Pass

READINESS LEVEL 1-10

SOLAR BATTERY PACKS

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

Complete one form per person

DENTAL INSURANCE PROVIDER:

MEDICATIONS CURRENTLY TAKING:

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

READINESS LEVEL 1-10

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

HYGIENE & SANITATION

This free template was provided by Southern Oregon Survival

READINESS LEVEL 1-10

914 SW 6 St., Grants Pass

READINESS LEVEL 1-10

HOME /PROPERTY PROTECTION:

EARLY WARNING SYSTEMS:

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

READINESS LEVEL 1-10

HEATING & COOLING

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

This free template was provided by Southern Oregon Survival

914 SW 6 St., Grants Pass

READINESS LEVEL 1-10