Redbridge e-forms Personal emergency evacuation plan form 1Your details2Ceremony details3Visual impairment?4Help required?5Hearing impairment6Wheelchair user?7Wheelchair details8Ability to transfer to evacuation chair?9Ability to use stairs10Other mobility aids11Additional impairments Complete this form at least 48 hours in advance of the wedding/civil partnership/citizenship ceremony. You will need to complete a form for each person with a disability or mobility issues attending on the day. Your detailsFirst name of person completing this form(Required) Last name of person completing this form(Required) Email(Required) Mobile phone number(Required) Ceremony detailsCeremony details(Required) Name of person with disability or mobility issues(Required) Name of friend or family member assisting(Required) Name of registrar or usher assigned to provide assistance(Required) Are they visually impaired?(Required) Yes No How severe is the visual impairment?(Required) Do they require help to evacuate the premises?(Required) Yes No Do they have a hearing impairment?(Required) Yes No How severe is the hearing impairment?(Required) Are they a wheelchair user?(Required) Yes, permanently Yes, occasionally No Do they use a manual or powered chair?(Required) Manual Powered Can they transfer from the wheelchair to an evacuation chair?(Required) Yes, with no assistance Yes, with assistance No Are they able to get down stairs and out exits safely in an emergency?(Required) Yes, completely independently Yes, with some support Yes, with support and evacuation chair No If the person is not a wheelchair user, what other mobility aids do they use?(Required) Crutches Walking stick Walking frame None Are there any further impairments or disabilities that may affect their ability to evacuate the building during fire alarm activations?(Required) Yes No Give details of these impairments or disabilities(Required)