Dental Office Emergency Evacuation Form

When an emergency strikes your dental practice, having a clear evacuation protocol can mean the difference between chaos and coordinated safety. This Dental Office Emergency Evacuation Form is designed specifically for dental practices to ensure complete accountability during fire alarms, natural disasters, or any situation requiring immediate facility evacuation.

Dental offices face unique evacuation challenges—patients may be mid-procedure with active equipment, nitrous oxide systems need immediate shutdown, and x-ray rooms require clearance verification. This template addresses these critical concerns while maintaining a complete headcount of both staff and patients.

Built for dental practice managers, office coordinators, and safety officers, this form streamlines the evacuation check-in process to account for patients in active treatment, verify proper equipment shutdown procedures, confirm clearance of specialized rooms, and establish complete staff accountability at your designated assembly point.

With Paperform's mobile-friendly design, evacuees can quickly check in on their phones at the assembly point, or designated safety officers can rapidly collect information on tablets. The form's conditional logic adapts to different emergency scenarios, and real-time submission tracking gives practice managers immediate visibility into who has been accounted for.

For practices managing multiple locations or requiring detailed incident documentation, connect this form to Stepper to automatically notify emergency contacts, log incidents in your practice management system, and trigger follow-up protocols based on the severity of the situation.

Whether you're conducting routine evacuation drills or responding to a real emergency, this template ensures your dental practice can quickly account for everyone on-site while verifying that critical safety protocols have been completed.