Wisconsin Emergency Information Form

State:
Multi-State
Control #:
US-1135BG
Format:
Word; 
Rich Text
Instant download

Description

The information provided on this form should be used in an emergency to notify specified individual(s) of a serious illness, injury, or incident. This information should remain confidential.

The Wisconsin Emergency Information Form is a comprehensive document designed to gather essential information about individuals in case of emergencies, ensuring their safety and well-being. It is an important tool used by emergency responders, healthcare providers, and officials to efficiently assist individuals during critical situations. This form aims to provide crucial details that aid in evaluating and addressing immediate needs, medical conditions, and special requirements of the individuals affected by emergencies. Keywords: Wisconsin Emergency Information Form, detailed description, emergencies, safety, well-being, emergency responders, healthcare providers, officials, critical situations, evaluate, address, immediate needs, medical conditions, special requirements. Different types of Wisconsin Emergency Information Forms: 1. Individual Emergency Information Form: This form is intended for individuals to fill out on their own, providing their personal and contact details, medical history, known allergies, medications, emergency contacts, primary healthcare provider, and any specific needs or instructions during emergencies. 2. Family Emergency Information Form: Designed for families, this form collects information about each family member, including minors, to ensure their safety and well-being during emergencies. It includes personal and contact details, medical history, allergies, medications, emergency contacts, primary healthcare providers, and any specific needs or instructions to cater to the entire family. 3. Employee Emergency Information Form: This form is specifically created for employers to have detailed knowledge of their employees' emergency contact information, medical conditions, allergies, medications, and any other pertinent information needed for their safety in case of workplace emergencies. This form helps employers to promptly address their employees' needs and prepare appropriate emergency response plans. 4. School Emergency Information Form: Aimed at ensuring the safety and well-being of students, this form is used by educational institutions to collect important details about students, including their personal and contact information, medical conditions, allergies, medications, emergency contacts, and any specific accommodations required during emergencies. It allows school staff and emergency responders to take appropriate actions for the students' well-being. 5. Senior Citizen Emergency Information Form: This specialized form focuses on gathering relevant information about seniors, including their personal and contact information, medical conditions, allergies, medications, emergency contacts, primary healthcare providers, and any specific needs or instructions unique to senior citizens. This form is particularly useful for assisting senior citizens during emergencies, considering their potential vulnerabilities and specific care requirements. By utilizing the Wisconsin Emergency Information Form that aligns with the specific situation or target group, emergency responders and officials can be well-equipped to provide appropriate assistance and prioritize the safety and well-being of individuals during critical incidents.

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FAQ

Have a household income at or below 80% of the county median income in the month of or prior to the application date and experienced financial hardship or significant costs due to the COVID-19 public health emergency. Be at risk of becoming homeless or experiencing unstable housing.

What does emergency rental assistance cover? The federal ERA Program allows local programs to cover rent, utilities, and home energy costs. This includes electricity, gas, fuel oil, water and sewer, and trash removal.

Your household may qualify if at least one or more individuals in your home meet the following: Qualifies for unemployment, or has experienced a reduction in household income or an increase in major costs/financial struggles due to COVID-19. Experiencing a risk of being evicted or losing your home.

Beginning February 22, 2021, Wisconsin residents that have experienced a significant loss of income due to the COVID-19 pandemic and need help with their rent or utility payments can apply for the Wisconsin Emergency Rental Assistance (WERA) program.

Evictions in Wisconsin have increased since moratorium ended, and may get worse if rental assistance delays continue. Published: Friday, October 1, 2021, am.

Couleecap helps people in need with housing, food, transportation, and more. Through our actions we fight poverty, promote self-sufficiency, economic development, social justice, and personal responsibility. My husband had a massive stroke two years ago that left him disabled and unable to work for a long time.

About the Program WHEDA currently works with local agents to serve residents in 48 Wisconsin counties where there are no community programs available. Eligible families pay between 30-40% of their adjusted income for rent. The balance is subsidized by the U.S. Department of Housing and Urban Development (HUD).

You must apply for Emergency Assistance at your local Wisconsin Works (W-2) Agency. Please visit the Find a W-2 Agency page for contact information.

More info

Application Process: Please fill out the Brown County ERA intake form here. Wisconsin Emergency Rental Assistance Program: Program ... Wisconsin Emergency Rental Assistance (WERA) is a COVID-19 response programeligible for help under WERA, start by completing this pre-screening form.We provide electric service to customers in portions of Wisconsin and Michigan's Upper Peninsula. We also serve natural gas customers in Wisconsin and steam ... This form provides information on the defendants current military servicethe court is required to order the debtor to file a financial disclosure ... Contact Emergency ServicesFor information pertaining to law enforcement agencies in your area, theAll others, please fill out the form above. Forms, guides, laws, and other information for landlord and tenant law.For information on the Wisconsin Emergency Rental Assistance Program please see ... Please read the Frequently Asked Questions sheet for program guidelines and eligibility. Agency. Phone Number. Online Contact. 1. ADVOCAP. 920-922-7760. Please read the Directions for Requesting Organization, complete the form and submit to the local public health department and/or local emergency manager in ... The form must state the medical condition, medical equipment and specific time period a shutoff ofform. For more information, call WPS at 800-450-7260. In an emergency, it's easy to forget even the most well-known information. That is why it's vital for you to fill out the information in this form for each ...

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Wisconsin Emergency Information Form