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Other Important Phone Numbers & Information: Other Important Phone Numbers & Information: Other Important Phone Numbers & Information: Important Information Name Telephone # Policy # Doctor(s): Other: Pharmacist: Medical Insurance: Homeowners/Rental Insurance: Veterinarian/Kennel (for pets): Other useful phone numbers: 9-1-1 for emergencies. Police Non-Emergency Phone Fire Non-Emergency Phone Printed by the Authority of the State of Illinois (IISG 665 - 10,000 - Web Revise 6/09) ---PAGE BREAK--- Out-of-State Contact Name: Telephone Number: Email: Telephone Number: Fill out the following information for each family member and keep it up to date. Name: Social Security Number: Date of Birth: Important Medical Information: Name: Social Security Number: Date of Birth: Important Medical Information: Name: Social Security Number: Date of Birth: Important Medical Information: Name: Social Security Number: Date of Birth: Important Medical Information: Name: Social Security Number: Date of Birth: Important Medical Information: Your family may not be together when disaster strikes, so plan how you will contact one another and review what you will do in different situations. Home Work Address: Address: Phone Number: Phone Number: Neighborhood Meeting Place: Evacuation Location: Regional Meeting Place: School Work Address: Address: Phone Number: Phone Number: Evacuation Location: Evacuation Location: School Other place you frequent: Address: Address: Phone Number: Phone Number: Evacuation Location: Evacuation Location: School Other place you frequent: Address: Address: Phone Number: Phone Number: Evacuation Location: Evacuation Location: Where to go in an emergency. Write down where your family spends the most time: work, school and other places you frequent. Schools, daycare providers, workplaces and apartment buildings should all have site-specific emergency plans. Every family member should carry a copy of this important information: Dial 9-1-1 for Emergencies! Dial 9-1-1 for Emergencies! Family Communications Plan Contact Name: Telephone: Out-of-State Contact Name: Telephone: Neighborhood Meeting Place: Meeting Place Telephone: Dial 9-1-1 for Emergencies! Family Communications Plan Contact Name: Telephone: Out-of-State Contact Name: Telephone: Neighborhood Meeting Place: Meeting Place Telephone: Family Communications Plan Contact Name: Telephone: Out-of-State Contact Name: Telephone: Neighborhood Meeting Place: Meeting Place Telephone: