(To Be Filled Out and Posted)

FIRE: Telephone Fire Department: Dial 911 Nearest Alarm Box: Dial 911

Crime: Telephone Police: Dial 911

Injury/Illness: Avoid infection of minor injuries; always get medical attention or skilled first aid

Employee(s) who are First Aid and/or CPR Certified

Doctor ________________________________________________________ Office _____________________________ Phone ____________________ Residence _____________________________ Phone ____________________

Hospital _______________________________________________________

Address _____________________________ Phone ____________________ Ambulance _________________________________________________________ Address _____________________________ Phone ____________________

In all cases of Fire, Crime, Accident, or Sickness, promptly notify:

1. Name: ____________________________________ Office Phone ______________ Home Phone ______________
2. Name: ____________________________________ Office Phone ______________ Home Phone ______________

Additional Numbers: _________________________ ________________________

(Alarm Company, Office Phone, etc.) ______________________________________ _____________________________________

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