Create an olnine disaster Family Plan.

Evacuation Level: _____
Where we’ll go if/when we need to evacuate.___________________________
Will I go to a host home?  ___ Yes ___ No
If Yes, list name, address and phone #: _______________________________

Does my employer provide a special shelter for me and my family?
___ Yes ___ No     
If Yes, list address and phone #: ____________________________________

________________________________________________________________

Will I go to a hotel/motel?  ___ Yes ___ No
Do they accept pets? ___ Yes ___ No
If Yes, list name, address and phone #: ______________________________

________________________________________________________________

If required, have I registered for Special Needs Evacuation Assistance?
___ Yes ___ No

   My pet(s) name/type of pet(s) ___________________________________

   What will I do with my pet(s) if I stay home? _______________________

   _____________________________________________________________

   What will I do with my pet(s) if I evacuate? ________________________

   _____________________________________________________________

How will I secure my boat? ________________________________________

Can I be a host home?  ___ Yes ___ No

If Yes, how many/who will I host? ___________________________________

_______________________________________________________________

What preventative measures will I take to safeguard my home? __________

_______________________________________________________________

_______________________________________________________________

Window/door protection arranged? ___ Yes ___ No

Are important papers copied and originals placed, with valuables,
in a waterproof, safe place?  ___ Yes ___ No
Location: ______________________________________________________

Copies placed: _________________________________________________

Safe room identified? ___ Yes ___ No
Location: ______________________________________________________

Have I obtained the elements of my survival kit? ___ Yes ___ No

                                       Company & Policy #                     Phone #

Home Owner’s SS#: _____________________________________________
Renter’s Insurance: _____________________________________________
Health Insurance: _______________________________________________
Flood Insurance: ________________________________________________
Auto Insurance: ________________________________________________

                                       Name                                               Phone #
Doctor: ________________________________________________________
Dentist: ________________________________________________________
School(s): ______________________________________________________
Day Care: ______________________________________________________
Family and friends to notify of our plans:_____________________________

_______________________________________________________________

_______________________________________________________________


Central Family Contact: ___________________________________________

_______________________________________________________________

_______________________________________________________________

Pinellas County Emergency Operations Center
Department of Emergency Management
Citizen Information Center
(727) 464-3800
(during an emergency activation call (727) 464-4333)