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Emergency Action Plan Template - Centers for Disease ...

Emergency Action plan ( Template ) Emergency Action plan for Facility Name: _____ Facility Address: _____ DATE PREPARED: ___/_____/_____ Emergency PERSONNEL NAMES AND phone NUMBERS DESIGNATED RESPONSIBLE OFFICIAL (Highest Ranking Manager at _____site, such as _____, _____, or _____): Name: phone : (_____) Emergency COORDINATOR: Name: phone : (_____) AREA/FLOOR MONITORS (If applicable): Area/Floor: Name: phone : (_____) Area/Floor: Name: phone : (_____) ASSISTANTS TO PHYSICALLY CHALLENGED (If applicable).

• Call medical emergency phone number (check applicable): Paramedics Ambulance Fire Department Other Provide the following information: a. Nature of medical emergency, b. Location of the emergency (address, building, room number), and c. Your name and phone number from which you are calling. • Do not move victim unless absolutely necessary. ...

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  Plan, Number, Action, Emergency, Phone, Emergency action plan, Phone number, Emergency phone number

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