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Incident and first aid records · IN-09

Emergency Evacuation Plan Sheet

A free printable evacuation plan sheet — routes and assembly points by area, who calls emergency services and takes the roll call, and who needs assistance getting out.

First page of the Emergency Evacuation Plan Sheet — Get the plan out of one person's head and onto a page everyone can read, so it still works on a day that person is not there.
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2 pages. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.

Print it and write on it

Fill it in type and save

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

What this sheet is for

Get the plan out of one person's head and onto a page everyone can read, so it still works on a day that person is not there.

Who it is for

Small workplaces, shops, village halls, clubs, holiday lets, care settings and anyone responsible for a building people gather in.

How to use it

  1. Name the building, who wrote the plan and the date it was written.
  2. Fill in a row per area or floor with the way out, the alternative and where people gather.
  3. Name a person and a deputy for each task, with the quickest way to reach them.
  4. List anyone who needs help getting out and the arrangement agreed with them.
  5. Note where the drill record and roll-call lists live, and pin a copy up.

What is on the sheet

2 pages, in this order:

Page 1

Printed under the title: The evacuation plan on one page — where people go, how they get out, who counts them, who makes the call, and who needs help.

One building, one plan. Routes, assembly points and who does what differ from building to building, so nothing is pre-printed here. Write the plan for this building, and put a copy up where people will actually see it.

Write-on lines: Building / site · Written by · Date written

Assembly and routes

Table, 4 rows: Area or floor · Primary route out · Alternative route · Assembly point

Who does what — one task to a row, with a named deputy

Table, 5 rows: Task · Named person · Deputy · How reached

Page 2

People who need assistance — and the arrangement agreed with them

Table, 4 rows: Name · Usual location · Assistance needed · Who assists · Agreed on

Ruled lines: Notes — where the drill record and roll-call lists are kept, and what changed at the last review

Questions

Why is nothing pre-printed on the plan?

Because a plan that came pre-filled would be describing somebody else's building. The routes, the assembly point and the names are the whole content of an evacuation plan, and only you can write them.

How is this different from the fire drill record?

This is the plan; the drill record is the test of it. Write this one first, then use the drill record to find out whether it works and what needs changing.

What about people who need assistance?

There is a block for them, filled in with them rather than about them — what help they need, who gives it, and the date it was agreed.

Related sheets

Fire Drill Record

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Emergency Contact Sheet

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