Free family worksheet

Make every alert someone’s job.

Name the first responder, backup, verification step, way into the home, and outage plan before anyone needs them.

Local form. Haven & Signal does not receive or store what you type. Entries stay in this open page unless you print or copy them; screenshots, browser extensions, printing, and shared-device access can create separate copies.

Local form. Haven & Signal does not receive or store what you type. Entries remain in this open page unless you print or copy them; screenshots, browser extensions, printing, and anyone with access to this device can create separate copies.

Haven & Signal · Family worksheet

Family Alert Response Plan

Keep one copy near the device and one with the family.

Who and what is this plan for?

Agree on one clear purpose. Avoid turning a safety signal into general surveillance.

Person this plan supports Service address Purpose agreed together Device or service What starts this plan?

Who responds?

Name people, order, and timing. “The family” is not a responder.

Primary responder Primary phone Acknowledge within Backup responder Backup phone Nearby person with access Nearby person’s phone

How do we verify, enter, and escalate?

Write actions that still make sense when someone is frightened or half awake.

First verification step Home access method Call 911 immediately when…

What happens when technology fails?

Use documented runtimes and provider instructions, not assumptions.

Documented backup runtime Provider support / monitoring number Outage or connection-loss action

Five-minute preflight

Check each item during a planned test, never during an invented emergency.

The monitoring-center or service number is saved in every responder’s phone. Primary and backup responders tested alerts through nighttime phone settings. A nearby person can reach the home without depending on the person inside. The family knows the provider-approved monthly test procedure. The power, internet, cellular, and caregiver-phone backup paths are understood.

Last tested Next review

Use it well

A device is only one link.

Agree togetherThe person living with the technology should understand its purpose and who receives information.

Test the chainUse the provider’s test process to verify the device, connection, contacts, access, and backup.

Review monthlyPhone settings, contact details, batteries, routines, and needs change quietly.

Read the response guide Set access boundaries