Are You Prepared for an

EMERGENCY?

Our free two-minute assessment will calculate your Emergency Preparedness Rating (EPR) and help you:

Understand the steps you can take to be prepared
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Are You Prepared for an

EMERGENCY?

Our free two-minute assessment will calculate your Emergency Preparedness Rating (EPR) and help you:

Understand the steps you can take to be prepared
Reward you with an instant discount on Emergency Alert Sticker Packs. $7.99 $5.99

In the Event of an Emergency:

Would first responders have immediate access to your vital medical information so they can treat you at the scene no matter where you were?

Yes No Not Sure

Would your Emergency Contacts be alerted immediately?

Yes No

Do you have a Designated Healthcare Surrogate?

Yes No

Would your surrogates/representatives be notified immediately no matter where they are?

Yes No

Do you have a Do Not Resuscitate (DNR) Order?

Yes No

Documentation:

Do you have the following legal documents in place?

Living Will

Healthcare directives

Medical power of attorney

Designated healthcare surrogate

Do Not Resuscitate (DNR) orders

Have your documents been updated within the last three years or since a change in situation?

Yes No Some

Could healthcare surrogates/family members access your important documents at a moment's notice, in order to represent your best interest?

Yes No

Family & Planning:

Please select your age group:

What is your marital status?

What type of residence do you live in?

Do you have living adult children?

Yes No

Do you have family members who live nearby?

Yes No

In case of a transition, would family members be able to access all of your personal and financial information?

Yes No

Do you have a comprehensive and communicated plan with family members to manage a life transition?

Yes No

Alert Technology:

Do you currently use/subscribe to an emergency alert service?

Yes No

What type of cell phone do you own/use?

iPhone

Android

Windows

Flip-Phone

I don't own a cell phone

Do you know about your iPhone's built-in Medical ID and Emergency SOS features?

Yes No

Have you set up your Medical ID so first responders could treat you at the scene and alert your emergency contacts?

Yes No / Not sure

Have you installed an ICE (In Case of Emergency) app on your android?

Yes No

Our easy-to-follow video tutorial will help you set up and configure your Medical ID and Emergency SOS. You can access it upon the completion of this assessment.

EIP has developed our very own ICE app, you can download and install here.

Before you continue...

(Your responses do not impact your results.)

Has this assessment been informative?

Very Informative

Considerably Informative

Somewhat Informative

Mildly Informative

Not informative

How prepared do you feel for an Emergency or Life Transition?

Extremely Prepared

Mostly Prepared

Somewhat Prepared

Not Prepared Enough

Not Prepared at All

Are you interested in learning more about life transition planning?

Yes No

You're almost done!

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6051 NW 24th Terrace
Boca Raton, FL 33496

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