Individualized Emergency Plan

Emergency Response Guidelines

If you have a disability — whether permanent, temporary, visible or invisible — and if you believe you may need help during an emergency, please complete this self-assessment form to identify barriers and possible solutions. Your input will help us prepare an emergency response plan that considers your needs.

The information collected is confidential and will only be shared with your consent. You do not have to provide details of your medical condition or disability in this form, only the type of help you may need in an emergency.

If you require this form in different format, or an in-person meeting, please contact Ginette Fedorchuk at 204.786.9400 or