When an emergency strikes an assisted living facility, every second counts. Whether it's a fire, natural disaster, or other crisis requiring evacuation, having a streamlined system to account for residents and their critical needs is essential for safety and peace of mind.

This Assisted Living Facility Evacuation Form template is designed to help care teams quickly check in residents during evacuations while capturing vital information needed to provide proper care at emergency gathering points or temporary shelters. The form documents each resident's location, medical requirements, mobility needs, and emergency contacts—ensuring no one is left behind and everyone receives the support they need.

Built for Senior Care Teams and Emergency Coordinators

Paperform makes it easy to deploy this evacuation checklist on mobile devices, allowing staff to check in residents as they exit the building or arrive at muster points. The clean, accessible design works perfectly on tablets and smartphones, so your team can focus on resident safety rather than wrestling with complicated technology.

You can customize the form to match your facility's specific protocols, add conditional logic to show relevant questions based on resident needs, and even include photo uploads for visual confirmation if required. Since Paperform works offline-first when embedded, you can continue collecting critical data even if network connectivity is disrupted during the emergency.

Automate Your Emergency Response Workflows

Connect this form to Stepper to automatically notify facility administrators, emergency coordinators, and family members as residents are checked in. You can create workflows that send SMS alerts to designated caregivers, update your resident tracking spreadsheet in real-time, and compile headcount reports that show who's been accounted for and who still needs to be located.

Integration with tools like Google Sheets, Airtable, or your facility management software means evacuation data flows directly into your systems without manual data entry—reducing errors when time is most critical. You can also set up automatic notifications to local emergency services or corporate headquarters with updated resident counts and special medical needs.

Compliance and Preparedness You Can Trust

Assisted living facilities operate under strict safety regulations, and emergency preparedness is a core compliance requirement. This template helps you maintain detailed evacuation records that demonstrate your facility's readiness and response capabilities. With Paperform's SOC 2 Type II compliance and secure data handling, you can trust that sensitive resident health information is protected even during high-stress situations.

Whether you manage a small residential care home or a large assisted living community, this evacuation form template gives you a reliable, mobile-friendly tool that works when it matters most. Customize it for your facility, train your staff, and have confidence that you're prepared to keep residents safe during any emergency.