---
title: Hospital Evacuation Patient Tracking Form Template | Paperform
description: Professional hospital evacuation checkin form for tracking patient location, mobility status, medical equipment needs, and evacuation team assignments during emergency situations.
url: "https://paperform.co/templates/hospital-evacuation-patient-tracking-form"
type: static
generatedAt: "2026-03-28T00:44:09.148Z"
---

[← Back to free form templates](/templates/)    ![Hospital Evacuation Patient Tracking Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/hospital-evacuation-patient-tracking-form.png)
    [Preview](https://_preview.paperform.co/ai-template/hospital-evacuation-patient-tracking-form) [Use this template for free](/create?ai-template=hospital-evacuation-patient-tracking-form)    [Emergency & Crisis Forms](/templates/category/emergency-crisis/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/) [Manager](/templates/role/manager/)[Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/)     About this free form template
When a hospital emergency evacuation is triggered, every second counts. Maintaining accurate patient tracking during an evacuation is critical for ensuring no one is left behind and that patients with special medical needs receive appropriate assistance. This **Hospital Evacuation Patient Tracking Form** provides a structured system for documenting patient locations, mobility status, medical equipment requirements, and evacuation team assignments in real time.

Built specifically for healthcare facilities, this evacuation checkin form helps incident commanders, nursing staff, and evacuation coordinators maintain accountability during crisis situations. Whether you're responding to fires, natural disasters, hazardous material incidents, or facility failures, this template ensures your team can quickly document which patients have been evacuated, where they came from, and what specialized support they require.

**Paperform makes emergency management more efficient** by allowing hospital staff to complete evacuation tracking forms on mobile devices in the field, instantly syncing data to a central dashboard. This means incident commanders can see real-time evacuation progress without relying on paper clipboards that can be lost or damaged during emergencies.

The form captures essential information including patient identifiers, original room numbers, mobility classifications (ambulatory, wheelchair, stretcher, or critical care transport), required medical equipment (oxygen, IV pumps, monitors, ventilators), and the specific evacuation team responsible for each patient. Conditional logic ensures staff only see relevant fields based on patient needs, streamlining data entry during high-stress situations.

For hospitals looking to further automate their emergency response workflows, **[Stepper](https://stepper.io)** can automatically route completed evacuation forms to designated incident command staff, update patient tracking spreadsheets, send notifications to department heads, and trigger follow-up safety checks—all without manual intervention. This level of automation ensures your emergency management team can focus on patient safety rather than administrative tasks.

This template is ideal for hospitals, medical centers, urgent care facilities, nursing homes, rehabilitation centers, and any healthcare facility that needs to maintain patient accountability during emergency evacuations. Whether you're conducting evacuation drills or responding to actual emergencies, having a standardized digital tracking system ensures better outcomes and complete documentation for post-incident review.
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