Can you leave the building unassisted?
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Can you move quickly in the event of an emergency?
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How far can you walk unaided?
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Do you find stairs difficult to use?
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Are you a wheelchair user?
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Has a member of staff and a deputy been assigned to assist you in an emergency?
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How might your mobility be worsened e.g. by smoke etc?
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Would you hear the fire alarm/an announcement informing you that there was an emergency?
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Would a visual indicator assist?
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Is there any special or purposely designed hearing system or device available which might assist you in hearing the fire alarm more clearly?
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If yes, please provide details:
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Would your response to a fire alarm being activated be helped by an assistant(s) who could provide support in the fire evacuation procedure?
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Would a vibrating pager unit that operated when the fire alarm was actuated be of assistance?
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Do you have strong enough eyesight to see your way out of the premises unaided?
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Can you read the escape instructions?
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If not, what format do you need them in?
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Do you require aid to help you move around the building (e.g. cane, guide dog)?
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How long does it take you to leave the building in normal circumstances?
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Could you find your way out of the building by an alternative route should your normal route be unavailable?
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Do you think the speed at which you leave the building may have the potential to hold up other people, or that they may cause you injury as they pass you?
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Would tactile signage or floor surface information be of assistance to you?
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Is there any other disability that may prevent you from evacuating without assistance?
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Are you able to understand what is happening in an emergency?
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Do you understand the risks?
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Do you understand the possible need for choice and change of direction during escape?
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How long does it take you to leave the building in normal circumstances?
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Do you understand the concept of a fire refuge area?
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Might the measures needed for your safe escape adversely affect the escape of other occupants?
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Do you think any special staff training is required to give you the assistance you would need?
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Do you understand the escape instructions given on your induction?
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Do you require a written copy of the specific emergency evacuation plan (SEEP)?
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Are the signs which mark the emergency exits clear enough?
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Could you raise the alarm if you discovered a fire?
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Are you likely to move around the building?
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Do you work out of hours?
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