Emergency Evacuation Report

Residence Hall:
Additional Details about Specific Location:
Date:
Month
Day
Year
Time:
: Hours
Minutes
AM/PM
Staff Member Completing Report:
Email Address of Staff Member:
Other residence life staff members present during alarm/evacuation (list by first and last name):
In the case of a fire drill, complete the next section:
Time required to complete evacuation was:
The drill was:
In the case of a false alarm, complete the next section:
Where was the alarm sounded?
Information on the cause/source of the alarm:
In the case of an actual emergency, complete the next section:
How was the emergency reported?
What was the nature of the emergency?
How was the emergency handled?
What was the outcome of the emergency?
For all of the above types of incidents, complete these last two questions:
Evaluate the cooperation of the residents:
Evaluate the performance of the staff:
Comments
This field is for validation purposes and should be left unchanged.