Coastal Health District Hurricane Registry Application Note: Please PRINT the entire form and mail it to your county health department. Registration must be updated and submitted annually. In an actual emergency, coordinating agencies will try to provide the necessary evacuation assistance, but this cannot always be assured. To best guarantee personal safety, individuals should make plans and follow government emergency evacuation guidelines. A personal caregiver SHOULD accompany you to the emergency shelter. The caregiver MUST be able to provide the same care at the shelter as is delivered at home. This may be for an extended period, 4-7 days or longer, depending on the event. Depending on your health status you may be transported to an American Red Cross emergency shelter or admitted to an inland healthcare facility. Shelters will provide no more than 20-40 square feet of space. (example: a cot with 1-2 feet of walk around space) Nursing Homes, Assisted Living Facilities, Personal Care Homes and In-patient Hospice facilities are responsible for the evacuation of their residents. Residents living in a nursing home, assisted living facility or personal care home MUST follow the emergency plan established by the facility’s administration. Residents under the care of in-home Hospice and Home Health Care Agencies should work with their providers to establish an emergency plan. This includes pre-determined destination and contact Information. There may be a cost associated with care or transportation if the client is placed in a healthcare facility
Coastal Health District Hurricane Registry Application Note: Please PRINT the entire form and mail it to your county health department. Registration must be updated and submitted annually. In an actual emergency, coordinating agencies will try to provide the necessary evacuation assistance, but this cannot always be assured. To best guarantee personal safety, individuals should make plans and follow government emergency evacuation guidelines. A personal caregiver SHOULD accompany you to the emergency shelter. The caregiver MUST be able to provide the same care at the shelter as is delivered at home. This may be for an extended period, 4-7 days or longer, depending on the event. Depending on your health status you may be transported to an American Red Cross emergency shelter or admitted to an inland healthcare facility. Shelters will provide no more than 20-40 square feet of space. (example: a cot with 1-2 feet of walk around space) Nursing Homes, Assisted Living Facilities, Personal Care Homes and In-patient Hospice facilities are responsible for the evacuation of their residents. Residents living in a nursing home, assisted living facility or personal care home MUST follow the emergency plan established by the facility’s administration. Residents under the care of in-home Hospice and Home Health Care Agencies should work with their providers to establish an emergency plan. This includes pre-determined destination and contact Information. There may be a cost associated with care or transportation if the client is placed in a healthcare facility