Take a look at example templates from schools
Dog Kennel Hill Primary School, a community school in Southwark, has a PEEP policy that includes a template plan (pages 8 and 9). On page 7, there is a checklist of 'points to consider' when completing the form.
Hoe Valley School, a secondary free school in Surrey, has a PEEP questionnaire and template on pages 10 to 12 of its evacuation procedures document.
See PEEP templates from local authorities
Dorset Council offers a template PEEP for schools. It includes space for recording details of the alarm system to be used, the evacuation procedure, designated assistance, equipment provided, and safe escape routes. Find the template