Venue Emergency Preparedness Form

Venue Emergency Preparedness Form
Assess and document your venue's readiness for emergency situations.
Venue Name
Venue Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Primary Emergency Contact Name
First NameLast Name
Primary Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Email
example@example.com
Is there an up-to-date, posted emergency evacuation plan?
Please rate the availability and condition of emergency equipment at the venue.
Rows Available Good Condition
First Aid Kit 1 2
Fire Extinguishers 3 4
Automated External Defibrillator (AED) 5 6
Emergency Lighting 7 8
Has the staff received emergency preparedness training in the past 12 months?
How often are emergency drills conducted at the venue?
What emergency communication methods are available?
Other
Please describe any recent emergency incidents or drills and actions taken.
Areas for improvement or additional resources needed for emergency preparedness:
Should be Empty:

Rows	Available	Good Condition
First Aid Kit	1	2
Fire Extinguishers	3	4
Automated External Defibrillator (AED)	5	6
Emergency Lighting	7	8

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