Emergency Telephone NumbersTelephone numbers may change over time, so periodically check yours for accuracy and update as needed. Sample Form: NAME OF YOUR FACILITY ____________________ YOUR ADDRESS _____________________________ TELEPHONE _________________________________ Facility Manager: NAME _______________________________________ DEPT/LOCATION ____________________________ WORK PHONE _______________________________ HOME PHONE ________________________________ Alternate Manager: NAME _______________________________________ DEPT/LOCATION _____________________________ WORK PHONE ________________________________ HOME PHONE In-House Phone Numbers: FIRE MARSHAL ______________________________ RISK MGMT __________________________________ EMERGENCY SVCS ___________________________ ERT PROGRAM MGR ___________________________ UPDATED AS OF _______________________________ Emergency Numbers: FIRE DEPARTMENT ____________________________ POLICE DEPARTMENT _________________________ PARAMEDICS/AMBULANCE ____________________ POISON CONTROL _____________________________ SUICIDE & CRISIS (24 HRS) _____________________ EMERGENCY BROADCAST SYSTEM _____________ AM FM__________ Utility Companies: GAS COMPANY ________________________________ ELECTRIC COMPANY ___________________________ WATER COMPANY ______________________________ Other Numbers: DEPARTMENT HEAD ____________________________ HOME __________________________________________ DIVISION HEAD _________________________________ HOME __________________________________________ |