Pharmacy Emergency Evacuation Form

When an emergency strikes, pharmacies face unique challenges that go far beyond a standard building evacuation. With controlled substances, temperature-sensitive medications, and patient safety at stake, having a structured evacuation protocol is critical.

This Pharmacy Emergency Evacuation Form provides a clear, step-by-step checklist designed specifically for pharmacies, compounding facilities, and hospital pharmacy departments. It ensures that pharmacists and pharmacy technicians can quickly account for all staff, secure high-risk inventory, protect refrigerated medications, and document prescription filling status—all while evacuating safely.

Who This Template Is For

This template is built for retail pharmacies, hospital pharmacy departments, long-term care pharmacy operations, and independent pharmacy owners who need a reliable emergency response protocol. It's particularly valuable for pharmacy managers, pharmacists-in-charge, and safety officers responsible for regulatory compliance and staff safety.

What Makes This Template Essential

Unlike generic evacuation forms, this template addresses pharmacy-specific risks including controlled substance security (required under DEA regulations), cold chain integrity for biologics and vaccines, and patient medication retrieval protocols. It creates a clear record of who evacuated, what security measures were taken, and what follow-up actions are needed—critical for both safety audits and insurance claims.

How Paperform Enhances Your Emergency Preparedness

With Paperform's mobile-friendly design, this form can be completed on any device during an evacuation, ensuring nothing is missed in the chaos. Conditional logic reveals only relevant questions based on the type of emergency, and automatic email notifications alert management and safety teams the moment the form is submitted.

You can also connect this form to your safety management system using Stepper (stepper.io) to automatically trigger post-evacuation protocols, notify emergency contacts, schedule facility inspections, and create incident reports—turning a crisis checklist into a complete emergency response workflow.

Whether you're preparing for fire drills, natural disasters, or hazardous material incidents, this template helps your pharmacy team respond quickly, document thoroughly, and protect what matters most: your people, your patients, and your controlled inventory.