PERSONAL EMERGENCY EVACUATION PLAN FOR by hands2urself

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									                               CONFIDENTIAL
          PERSONAL EMERGENCY EVACUATION PLAN FOR:
Name
Department
Building
Floor(s)
Room(s)
Dates from/to

Awareness of the alarm signal, response to it, and evacuation or other planned action will be
ensured by the following standard, generic methods (as per DCLG fire safety guidance and
Appendix B of the building Fire Emergency Plan): _________________________________


Persons Designated to Assist
The following have been designated to provide evacuation assistance:

Name/function
Contact details
Type of assistance

Name/function
Contact details
Type of assistance

Name/function
Contact details
Type of assistance



Assistance Methods and Cautions (transfer methods, contra-indications, etc.)
Equipment (including communication)




Action to take on entering Premises/Area/Room




Action to take on Alarm Signal




Safe Route(s)




Signed (all relevant persons):                  (Print names & date)

								
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