Personal Safety Plan

Personal Safety Plan — Form Fields

This personal template includes 7 fields. Document your personal safety plan including emergency contacts, safe meeting places, and important information to have on hand in case of emergency. A valuable reference for any unexpected situation. Free to customize and use on ZenBuild.

• Full Name (text, required)
• Primary emergency contact name and phone (text, required)
• Secondary emergency contact name and phone (text, optional)
• Medical information (allergies, medications, conditions) (long text, optional)
• Safe meeting place near home (text, optional)
• Do you have an emergency kit at home? (dropdown selection, optional) — options: Yes — fully stocked, Partial — needs updating, No — I should get one
• Other important notes (long text, optional)