Our 3-Step Escape Plan

  • First Escape Route
  • Second Escape Route
  • Meeting Place

Use this space to note any additional information about your escape plan, i.e. who will assist

Your checklist
  • Get low

    Smoke is poisonous and more deadly than flames.

    If you breathe smoke for more than a few breaths it can kill you.

  • Be fast

    A house fire can kill you in less than three minutes.

    Don't spend time trying to save possessions.

  • Close doors

    A closed door buys you time.

    It slows down the spread of fire, giving you more time to get to safety.

  • Get out - stay out!

    People have died by going back into a fire.

    Don't leave the meeting place to go back inside for any reason.

Refer a Home Fire Safety Visit

Referrer details

Referring agency

Contact details - referee

Use format: 021 222 3333 or +64 4 555 6666

Use format: 123 Street Name, Suburb, City, Postcode


Is this person Deaf or using hearing aids?

Use format: 021 222 3333 or +64 4 555 6666

Smoke alarms

Does the contact have working smoke alarms installed?
Smoke alarm floor plan landscape

I confirm that I have the referee’s consent to share the information in this form with Fire and Emergency New Zealand for the purpose of a Home Fire Safety Visit.