The Household Count
Who is in this house
Write the people who live here, and the animals who live with them. Leave a row blank when it does not apply. This sheet is the roster. Water, medicines, and pets each have their own page.
The place
People
One row per person. Age is optional. Do not write a Social Security number.
Add a row only if it applies
A diagnosis stays off this page unless a clinician says a responder must see it. Infant feeding is whatever this house already does. Animals are named here and planned on the pet sheet.
Fiction. Not your house.
An apartment. Two adults and an infant. One adult is often at work. The infant is at home. This sample writes English and leaves every other language blank. No older adult lives here, and no disability is stated. One dog lives here. One medicine is refrigerated.
The dog’s food and water stay on the pet sheet, with no gallon number. The medicine’s name, dose, and day-count stay on the medicine sheet, and that sample leaves all three blank. No Social Security number is written.
Roster fields follow Ready.gov Make a Plan, 1 September 2026: ages, places people go, diet and medical needs, disabilities, languages, pets or service animals, and school-aged children. This file is not an official FEMA publication. In a life-threatening emergency, call 911. This file is not on sale.