SES - Home Emergency Plan Checklist

• Conducted on

  Date

• Prepared by

• What is your email address?

• Location
  Address

• Postcode

• Address

• Type of residence

  House

  Apartment

  Townhouse

  Farm

• Are you located in a flood zone or near river catchments?

  Yes

  No

  N/A

• What flood level in metres will place your property at risk?

Dependents

• Who else lives with you?

• What are their phone numbers?

• List of all pets, companion animals and assistance animals living in your household

• Has your property been flooded before?

  Yes

  No

  N/A

• When did the flooding occur?

  Date

• Can you provide a description regarding the extent of the damage?

• Who is your gas service provider?

• What is their contact number?

• Who is your water service provider?

• What is their phone number?

• Who is your electricity service provider?

• What is their phone number?

• Do you have a waterproof document holder?

  Yes

  No

  N/A

• How confident are you to manage a flooding event (on a scale of 1 being low and 10 being high)?

• Do you have a willingness to put the plan of action in place?

  Yes

  No

  N/A