Disaster Evacuation Plan Evaluation Form

Evaluator's Full Name

First NameLast Name

Date of Evaluation

Date

Location of Evacuation Plan

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

How clear was the evacuation route?

How effective was the communication during the evacuation?

Were all safety measures adequately addressed?

Additional Comments

Evaluator Signature