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Personal Emergency Evacuation Plan

"*" indicates required fields

Address:*
DD slash MM slash YYYY

Reason for PEEP:

  • Mobility Issues
  • Mental Health Issues
  • Learning Disabilities
  • Hearing Issues
  • Visual Issues
  • Other Health Issues
Reason for PEEP?*
Mobility Issues:*
Hearing Issues:*
Visual Issues:*
Other Health Issues:*

Procedure in the event of an emergency

Method of Assistance:*
After hearing the first alarm or discovering an emergency.
State how this information has been communicated to the client and/or relatives if appropriate.
Awareness of procedure agreement:*
Clear Signature
DD slash MM slash YYYY
Clear Signature
DD slash MM slash YYYY
Schedule the review of the peep in line with care plan review:*
Scheduled date of next review:
Any changes in condition/location:
Manager Name:
Date of Review:
 
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In support of

Hazelwood Homecare in support of The Homecare Association
Hazelwood Homecare in support of Dementia Friends

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Rated GOOD in all areas by the care quality commission.
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Copyright 1985 – 2021 — All Rights Reserved —
Hazelwood Homecare Ltd
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Hazelwood Homecare
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