Free Emergency Contact Form (Fillable PDF, Word, Excel)

What is on the emergency contact form

Two contacts, two numbers each

The first contact is often unreachable. Two people, each with a mobile and an alternate number, is the minimum that works at 2 a.m.

Relationship

Tells a responder who they are talking to and whether that person can make decisions.

Physician and preferred hospital

Where the person's records are. Paramedics will go to the nearest appropriate hospital, but the physician's name gets the history faster.

Insurance

Insurer, member number and phone. Voluntary on the employee form; hospitals will treat first and ask later, but having it avoids a delay in admission.

Allergies, conditions, medications

Voluntary and the person's own words. Drug allergies, asthma, diabetes, epilepsy, anticoagulants and severe food allergies are the ones responders most need.

Pickup authorization and not-permitted (student form)

Who may collect the child, who may be called, and who may not. Attach any court order.

Consent to treat

Permission to seek emergency treatment when the person cannot consent or the parent cannot be reached. Standard wording is included; adapt to your organization's counsel.

Why organizations keep emergency contact forms

No US federal law requires employers to collect emergency contacts, but OSHA expects workplaces to have an emergency action plan and nearly every workplace injury investigation starts with "who did you call?". Schools and licensed childcare are different: state licensing rules in all 50 states require emergency contact and authorized-pickup information for every child, with a consent-to-treat, and they require it to be kept current. Camps, youth sports, church groups and volunteer organizations follow the same practice because their insurers require it.

The form is also a privacy document. Medical information collected from employees must be kept seperate from the personnel file under the ADA, which is why the employee version says medical details are voluntary and sealed. For children, the information is shared only with staff who need it (the teacher, the nurse, the trip leader), and under FERPA a school may disclose it to responders in an emergency.

Which form to use

• Employee: collected at hire with the employee information form, reviewed annually. One page, sealed.
• Student / child: schools, daycares, after-school programs, camps, clubs. Two parents, authorized and non-authorized pickups, medical, insurance, consent.
• Volunteer / participant: adults on trips, retreats, work days, sports teams, events. Contacts, medical, insurance, consent, optional photo release.

How to use it

1. Collect the form before the person starts or before the event, not on the day.
2. Check that two contacts are listed with working numbers. Call one if you can; wrong numbers are the most common defect.
3. Store it where the person responsible can reach it in seconds: a sealed envelope in the file, a binder at the first-aid station, a folder in the trip leader's bag.
4. Review it once a year, and on any change of address, family situation or health.
5. When someone leaves, shred it with the rest of the confidential file after the retention period.

Mistakes that make the form useless in an emergency

• Only one contact, or two contacts who live together with one phone.
• Forms filed in a locked cabinet whose key is with someone who has gone home.
• Information three years old. Phones change; so do relationships.
• Medical information copied into the general personnel file or an email.
• No consent-to-treat on a child's form which delays care when a parent cannot be reached.

Related sheets

For the home, the family emergency contact sheet is the fridge-door version with doctors, utilities and neighbors. For trips, the travel emergency contact sheet adds embassy, insurer and itinerary details. The allergy card is the wallet-sized piece that goes with the person.

Editing the Word and Excel versions

Use the Word version to add your organization's name, logo and your counsel's consent wording; the standard consent text is a starting point, not legal advice. The Excel version is a fillable layout that can be exported into a roster. All three forms print on one page in Letter or A4. For a class or a team, print the student or participant form double-sided with your activity information on the back.

Questions

Is an employer required to collect emergency contacts?

Not by federal law, but it's expected under OSHA emergency planning and is standard practice. Schools and licensed childcare are required to by state licensing rules.

Can I require employees to give medical information?

No. Medical details on the employee form are voluntary and must be kept in a separate confidential file under the ADA. Emergency contact names and numbers can be required.

Is the consent-to-treat line legally binding?

It's widely used and generally respected by medical providers when a parent or the person can't be reached, but wording and effect vary by state. Have your counsel confirm the wording for your organization.

How often should the form be updated?

At least once a year, and whenever the person tells you something changed. Schools usually re-collect at the start of each year.

Can the form be filled on a phone or tablet?

Yes. The PDF is fillable, so it can be emailed to parents or participants, completed in a PDF reader and returned.