| Parent's Name | Names of Parents: _______________________________________________ |
| Children's names/ages: | _____________________________________________________________ |
| Emergency Number (Police/Fire) | 911 __________________________________________________________ |
| Doctor: | David M. Millsaps, MD FAAP, Unifour Pediatrics Phone Number 828-328-1118, or for major emergency call 911. |
| Neighbor | Name: _______________________________, Phone:___________________ |
| Nearest Relative | Name: _______________________________, Phone:___________________ |
| Father's Work | Name: _______________________________, Phone:___________________ |
| Mother's Work | Name: _______________________________, Phone:___________________ |
| Electric Company | Name: _______________________________, Phone:___________________ |
| Gas Company | Name: _______________________________, Phone:___________________ |
| If a crisis occurs, try to get in touch with Mother or Father first, but not if delaying matters in an emergency. | Dad's Cellular: __________________, Mom's Cellular: ___________________ Will be at: _______________________________, Phone:_________________ Time expected home:______________________________________________ |
| Locks: | ______________________________________________________________ |
| Lights: | ______________________________________________________________ |
| Fire extinguisher (location): | ______________________________________________________________ |
| What to do if there is a power failure: |
______________________________________________________________ |
| Visitors: | ______________________________________________________________ |
| What to do if the smoke detector goes off: |
______________________________________________________________ |
| Message to give if someone calls: |
______________________________________________________________ |
| Use of fireplace | ______________________________________________________________ |
Water crisis (location of main water valve): |
______________________________________________________________ |
Food |
______________________________________________________________ |
Other: |
______________________________________________________________ |
| Written by E. Christophersen, Ph.D., author of "Baby Owner's Manual: What to Expect and How to Survive Heavily modified and adapted for this use. |
|