ST. JOHNS COUNTY
St. Johns County Emergency Management | 100 EOC Drive | St. Augustine, FL 32092
EVACUATION ASSISTANCE REGISTRATION FORM
Phone (904) 824-5550 | Fax (904) 824-9920
Online Registration: www.sjcemergencymanagement.org
|The Evacuation Assistance Program is for any
citizen of St. Johns County who needs assistance during a disaster situation
requiring evacuation to a Public Shelter or a Special Needs Shelter. A Special
Needs Shelter is capable of providing limited medical care only. If you require
ambulance transportation and / or hospital facilities you or your care-giver
should make those arrangements ahead of time. Shelters should be your refuge of
last resort if you have absolutely no where else to go.
Residents of nursing homes, convalescent homes, retirement homes, assisted
living facilities, or other group facilities, will look to the management of
their facility for an organized group evacuation. Under Florida State Statute
252 it is required these facilities have an Emergency Plan to evacuate their
residents to a predetermined location outside the evacuation area.
All records, data, information, and correspondence relating to the registrants
of the Evacuation Assistance Program are confidential and exempt from
disclosure and can be made available only to other emergency response agencies
(Section 252.355, Florida State Statute).
This form must be
completed in full or it will be returned to you. Please print clearly.
DATE OF BIRTH:
DO YOU HAVE PETS:
If yes, type and
number of animals:
PERSON COMPLETING FORM: