Okay... I've done a little digging about this and it seems it MAY be a response to the following January 2007 Kingdom Ministry article :
Are You Prepared for a Natural Disaster?
1. Why is it prudent to be prepared for disasters?
Each year, millions of people around the world, including many of our brothers and sisters, are affected by earthquakes, tsunamis, monsoons, hurricanes, tornadoes, and floods. Since natural disasters occur unexpectedly and could affect any of us, it is the course of wisdom to be prepared.—Prov. 21:5.
2. Why should we keep the elders informed of our current address and telephone number(s)?
In Advance: Sometimes the authorities are able to warn of impending disasters. It is important to pay attention to those warnings. (Prov. 22:3) In such situations the elders will try to contact all in the congregation to help them to make necessary preparations. After a disaster, the elders will also endeavour to contact all who are associated with the congregation to see if they are safe and to discern what assistance may be needed. Valuable time can be lost if the elders do not have up-to-date contact information. So it is good for publishers to keep the secretary and their book study overseer informed of their current address and telephone number(s).
3. How may we cooperate with the elders if we live in a disaster-prone area?
If the congregation is located in a disaster-prone area, the elders may ask publishers to provide the name and telephone number of a relative or friend who does not live in the vicinity and who should be contacted in case of an emergency. This will enable the elders to locate those who have evacuated. The elders may also wish to develop a contingency plan for the congregation that includes such things as a simple checklist of emergency supplies to keep on hand, evacuation arrangements, and plans for assisting those with special needs. Cooperation with these loving arrangements is important.—Heb. 13:17.
4. What should we do if a disaster strikes in our area?
After a Disaster: What should you do if a disaster strikes in your area? Make sure that your family's immediate physical needs are cared for. As you are able, give necessary assistance to others who have been affected. Endeavour to contact your book study overseer or another elder as soon as possible. This should be done even if you are safe and do not need help. If you need assistance, be assured that your brothers are making every effort to help you. (1 Cor. 13:4, 7) Remember that Jehovah is aware of your situation; rely on him to sustain you. (Ps. 37:39; 62:8) Be alert to opportunities to provide spiritual and emotional support to others. (2 Cor. 1:3, 4) Resume your theocratic routine as soon as possible.—Matt. 6:33.
5. How are we as Christians affected by the threat of disaster?
While the threat of disaster causes the world much anxiety, we can look to the future with confidence. Soon all disasters will be a thing of the past. (Rev. 21:4) In the meantime, we can take reasonable steps to prepare for times of trouble and difficulties as we maintain our zeal in declaring the good news to others.
It also seems that this may be more of an issue to disaster prone areas, hence there doesn't seem to be a national / international form for this.
It seems that it has been left to individual congregations to sort this out.
I have just received a SAMPLE form for this.