Form - Emergency Planning and Response Checklist

Published on Jan 1, 2023

Emergency Planning and Response Checklist form in WorkSignals

Introducing WorkSignal's Emergency Planning and Response Checklist, part of the Checklists form family. This form brings together relevant data points related to emergency preparedness, response, and safety protocols. Use this form to ensure you are prepared for any disruptive events or incidents.

Similar forms include Incident Status and Emergency Response Time, both located in the same category. Take advantage of WorkSignal's integrated suite and use this form in conjunction with assessment forms such as Electrical Inspection and Ventilation Testing.

The Emergency Planning and Response Checklist form is part of the WorkSignals forms suite, and is part of the Checklists category.

The Emergency Planning and Response Checklist form contains the following fields:

  • Creation Date (Type: Date Select)
  • Emergency plan (Type: Heading)
  • Is there a written emergency plan in place? (Type: Pass/Fail)
  • Are emergency contact numbers posted and easily accessible? (Type: Pass/Fail)
  • Evacuation procedures (Type: Heading)
  • Are evacuation diagrams posted in visible locations? (Type: Pass/Fail)
  • Are evacuation routes clear and unobstructed? (Type: Pass/Fail)
  • Is there a designated assembly area? (Type: Pass/Fail)
  • Fire Safety (Type: Heading)
  • Is emergency lighting installed and functional? (Type: Pass/Fail)
  • Are fire extinguishers present, accessible, and inspected regularly? (Type: Pass/Fail)
  • Is the fire alarm system operational and tested regularly? (Type: Pass/Fail)
  • Are smoke detectors installed and tested regularly? (Type: Pass/Fail)
  • First Aid (Type: Heading)
  • Are first aid kits accessible and stocked with required supplies? (Type: Pass/Fail)
  • Is there a designated first aid officer? (Type: Pass/Fail)
  • Training & Drills (Type: Heading)
  • Have employees received emergency response training? (Type: Pass/Fail)
  • Are emergency drills conducted regularly? (Type: Pass/Fail)
  • General Emergency Preparedness (Type: Heading)
  • Is there an emergency communication system in place? (Type: Pass/Fail)
  • Is there a lockdown procedure in place for security threats? (Type: Pass/Fail)
  • Is emergency equipment (e.g., AED, eyewash stations) available and functional? (Type: Pass/Fail)
  • Is the emergency plan reviewed and updated regularly? (Type: Pass/Fail)
  • Additional Notes (Type: Text Entry (Multiline))
  • Follow Up Tasks (Type: Add entry to list)

Here's a preview of the Emergency Planning and Response Checklist form inside the mobile app:

Image of a Emergency Planning and Response Checklist form

Get started with a Emergency Planning and Response Checklist form

It's free to set up an account and start creating your own. Use WorkSignals to create Emergency Planning and Response Checklist free.

Forms in checklists:

Assets in checklists:

Book a Call or Demo
No obligation or hard sales, just a friendly chat about what we offer