Autism Spectrum Disorder (Asd) Safety Planning Packet printable pdf download

(ASD) Emergency Contact Form

Date Submitted: Department of Transportation: ______ School: ________

Autism Spectrum Disorder (ASD) Emergency Planning

Parent/Family Tip Sheet:

It can be very important plan ahead as a family proactively in case of an emergency, but contemplating

organizing this can be a challenging task for a person with ASD. The following are some family friendly tips to

assist family members/caregivers when formulating emergency safety plans for their loved one on the ASD

Spectrum.

Proactive Planning Tips:

1) Decide how you as a parent or caregiver will contact other family members, friends or

community supports and what you will all do if there is an emergency.

a. Consider devising a plan with family and friends to divide up responsibilities for to

contacting first responders and searching the main places the person with ASD may

go within the community (consider identifying the most dangerous locations nearby).

2) Create an emergency point person who can contact

3) Complete the attached Emergency Contact form (or other safety form) and consider keeping

in the glove compartment of your vehicle (along with ASD awareness sticker/magnet on

bumper of your car and your glove compartment) just in case of an emergency.

4) If you have not already done so, go to your local Department of Transportation to register

your son or daughter for a state identification card.

** Share the completed ASD Emergency Form with Iowa Department of Transportation

professionals when completing application for State ID card and ask that this information be

attached to the person with ASD’s State of Iowa ID number.

See Link:

Iowa State Identification Issuance sites:

Identification Fee: See Link:

Overview:

The cost of the ID is $8.

There is no age limit.

The ID cards are good for 8 years.

The Cedar Rapids office is quiet efficient – (Tuesday and Saturday – very busy).

5. Ask about facial recognition software as this is offered

5) Consider forwarding your safety planning packet to your child’s educational team. If your

school has an electronic student registration, check for areas that you could add a

safety/emergency plan and alert school staff you have added the information to the student’s

registration information.

If your student attends the Cedar Rapids Community School District you can access E-

Registration by logging into Powerschool. Within the registration section, click on the “Health”

tab and add a “Health Concern”. Choose “Autism” from the drop down box and then add

safety information and other details to the box on the right.

Contact ask your local dispatch office via non-emergency contact to request that this

information be added to the 911 computer data base.

In Linn County:

Non-Emergency Number: 319.892.6100

Autism Spectrum Disorder (Asd) Safety Planning Packet