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Employee Emergency Contact List Form Template

Streamline Your Employee Emergency Contact Collection Process

Knowing who to reach in an emergency is crucial, but gathering contact details from employees can be challenging. This Employee Emergency Contact List Form Template helps you collect essential information efficiently while ensuring your records are always up to date. Easily integrate custom fields, share across devices, and keep your workforce informed when it matters most, not to mention the added peace of mind for everyone involved. Explore how this template can simplify your emergency contact management.

Full legal name
Job title
Department or team
Employee ID or number
Work location or site
Home address (include street, city, state, ZIP)
Date of birth
Primary phone
Alternate phone (optional)
Work email
Personal email (optional)
Preferred language for emergency communication
English
Spanish
Chinese
French
Arabic
Prefer not to say
Other
Please Specify:
Contact full name
Relationship to employee
Please Specify:
Primary phone
Alternate phone (optional)
Email (optional)
Preferred contact method
Call
Text message
Email
Any
Lives with the employee?
Yes
No
Authorized to receive or share medical information in an emergency, if needed?
Yes
No
Contact full name (optional)
Relationship to employee (optional)
Please Specify:
Primary phone (optional)
Alternate phone (optional)
Email (optional)
Preferred contact method (optional)
Call
Text message
Email
Any
Lives with the employee? (optional)
Yes
No
Authorized to receive or share medical information in an emergency, if needed? (optional)
Yes
No
Relevant medical conditions (optional)
Allergies (optional)
Medications (optional)
Primary care physician name (optional)
Physician phone (optional)
Preferred hospital or clinic (optional)
Health insurance provider and policy/group number (optional)
If necessary, share this information with emergency responders
Yes
No
I confirm the information provided is accurate to the best of my knowledge
True
False
Employee signature (type full name)
Date signed
I will notify HR if any of this information changes
True
False
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Paper art illustration showing an employee emergency contact list form design in a creative layout

When to use this form

Use this template during onboarding, safety drills, and field operations when you need reliable, up-to-date contacts for every employee. It is also useful after org changes, like new phone systems or team moves, to prevent gaps in communication. HR and people managers get a clean list they can trust; safety leads get fast access during incidents. Pair it with the Employee contact information form to keep phone and email details consistent. For legal or benefits needs, add the Next of kin form. If your team works offsite or on shifts, the Digital emergency contact form lets employees update details from their phone so you always have a clear call order.

Must Ask Employee Emergency Contact List Questions

  1. Who should we contact first in an emergency, and what is their relationship to you?

    A clear priority order prevents delays when minutes matter. Relationship details help confirm we are speaking with the right person.

  2. What are the primary and backup phone numbers for each contact, and what is their preferred method (call or text)?

    Multiple numbers and a stated preference improve the chance of reaching someone fast. This reduces back-and-forth and speeds decisions.

  3. What is your full name, job title, department, and usual work location or shift?

    These fields help us identify the right person quickly and guide responders to you. They also align records with the Employee information form, reducing errors across systems.

  4. Do you have any medical notes first responders should know (for example, allergies, conditions, or medications)?

    Optional medical notes help responders act fast and avoid risks. Collect only essential details needed during an emergency to respect privacy.

  5. When was this information last verified, and do you consent to use and share it during emergencies?

    A verification date prompts regular updates and maintains accuracy. Consent supports compliance and lets us share details with responders without delay.

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