Templates
PEEPs fire safety template

PEEPs fire safety template

Create personalized evacuation plans that document specific assistance needs for people with disabilities.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF
PEEPs fire safety template

Create personalized evacuation plans that document specific assistance needs for people with disabilities.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

Fire emergencies demand quick action, but standard evacuation procedures often overlook those with special needs. This PEEPs fire safety template lets you create individualized evacuation plans that account for mobility challenges, sensory impairments, or other conditions requiring assistance. Rather than scrambling during an emergency, you’ll have a documented plan detailing specific support needs, assistive devices, and emergency contacts.

The Harvard University Center for the Environment states that individuals with disabilities face two to four times higher risk of injury or death during climate emergencies like wildfires and floods . By implementing this template, you transform this concerning statistic into actionable safety measures that protect everyone in your building.

Related categories

Preview of the template
Page 1
Personal Information
Full Name
Building/Floor/Room
Primary Contact Number
Secondary Contact Number
Emergency Assistance Needs
Do you have any disabilities or conditions that may require assistance during an emergency evacuation?
If yes, please describe the assistance you may require
Do you use any assistive devices (e.g., wheelchair, walker, cane)?
If yes, please describe the device(s) you use
Emergency Contacts
Primary Emergency Contact Name
Primary Emergency Contact Phone
Secondary Emergency Contact Name
Secondary Emergency Contact Phone
Evacuation Plan
Are you familiar with the emergency evacuation procedures for your building?
Have you identified the nearest emergency exits and assembly areas?
Do you require any special assistance to evacuate the building?
If yes, please describe the assistance you may require
Have you practiced your emergency evacuation plan?

Frequently asked questions

How do you determine if someone needs a PEEPS fire safety plan?

Conduct confidential conversations with employees about their evacuation needs. Look for mobility, vision, hearing, or cognitive challenges that may affect evacuation. Consider temporary conditions like pregnancy or injury. Always respect privacy while ensuring safety needs are properly documented.

What information should you include about assistive devices in a PEEPS template?

Include the type of device, its location, whether it can be evacuated with the person, and any special handling requirements. Also note if backup devices exist, who is trained to operate them, and whether they require maintenance that could affect evacuation procedures.

How can you make sure designated helpers understand their role in a PEEPS plan?

Provide specific training for helpers on assisting techniques, communication methods, and equipment handling. Include them in practice drills with the individual. Create backup plans with alternative helpers and conduct regular refresher sessions so everyone understands their responsibilities.

What legal requirements should you consider when implementing PEEPS templates?

Check your local fire safety regulations for specific PEEPS requirements. Consider equality and disability legislation that mandates reasonable accommodations. Document your compliance efforts, including template implementation, staff training, and regular reviews to demonstrate due diligence.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.