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Employee Emergency Contact Form

What do you do if your employee gets sick at work and they can’t drive themselves home? Or what if they haven’t shown up in multiple days? When things like this happen at work, you’ll want to know who to call. A great way to make sure you have this information is by creating an employee emergency contact form. In this article, we’ll teach you how to make one.

What Is an Employee Emergency Contact Form?

An employee emergency contact form is an onboarding document that employees can fill out to provide you, the employer, with their emergency contact information. They can also provide any other information that they think you might need to know in case of an emergency, such as food allergies or allergies to any medications.

Why Having Employees Fill Out an Emergency Contact Form Is So Important

Below are a few ways the emergency contact employee forms help ensure your employees’ safety and wellbeing.

  • To help the employee obtain medical assistance. If your employee is injured at work, you may need to contact their emergency contact to help them get the medical care they need. Or, if they’re sick but don’t want to go to the hospital, they may need a ride home.
  • To be able to respond to a medical emergency. If an employee is experiencing a medical emergency at work, you should call 911. In the interim, the employee may have provided important information that can help you or the emergency medical personnel respond.
  • To inform emergency contacts if you can’t locate your employee. Unfortunately, you may run into a situation where you can’t find your employee. If they’re not showing up to work and you can’t locate or contact them, you’ll want to let their emergency contact know.

What To Ask for on an Emergency Contact Form

Ask for the following information on your emergency contact form:

1. The Employee’s Information

If your company keeps paper files, make sure to add the employee’s name, job title, or department. Although the form should always be in the personnel file, documents do sometimes get misplaced. You’ll want to be able to confirm who the form belongs to.

2. Primary Emergency Contact

Having more than one emergency contact is helpful in case your first contact doesn’t answer their phone. Be sure to ask for the emergency contact’s cell phone number, their work phone number and their email.

Also, ask whether you can share medical information with the emergency contact.

3. Secondary Emergency Contact

Just like the primary emergency contact, ask for the secondary contact’s relationship to your employee, their cell phone number, their work phone number and their email. The secondary emergency contact should only be called if the primary emergency contact can’t be reached.

Again, also ask whether you can share medical information with the emergency contact.

4. Home Information

You may need the employee’s home information if you’re trying to help locate the employee, or if you want to contact employees to tell them not to come in due to bad weather.

5. Voluntary Additional Information

Although it can be helpful to have certain medical information, it’s very important that you make it clear with your employees that sharing any medical information is completely voluntary. You may want to add a sentence to the form explaining that the purpose of sharing information would be to help you respond to an emergency. You can also give examples, such as allergies to certain medications.

Free Emergency Contact Form Template

Name:

_____________________________

Job/Title:

_____________________________

Cell Phone:

_____________________________

Home Phone:

_____________________________

Date:

_____________________________

Your Home Address

_________________________________________

_________________________________________

Primary Emergency Contact

Name:

_____________________________

Cell Phone:

_____________________________

Work Phone:

_____________________________

Email:

_____________________________

Would you like us to share relevant medical information with this person in case of a medical emergency?

Yes / No

Secondary Emergency Contact

Name:

_____________________________

Cell Phone:

_____________________________

Work Phone:

_____________________________

Email:

_____________________________

Would you like us to share relevant medical information with this person in case of a medical emergency?

Yes / No

Voluntary Disclosure of Emergency Medical Information

If you would like to disclose any medical information that would help us respond to a medical emergency, such as food allergies, please use the space below to share.

Allergies:

__________________________________________________________

Medical Alerts:

___________________________________________________________

_________________________________________________________________

_________________________________________________________________

When To Reach Out to an Employee’s Emergency Contact

The following are some examples of situations when you may need to reach out to your employee’s emergency contact:

  • When your employee gets sick and you have to call 911.
  • When your employee is sent to the hospital.
  • If a friend, roommate or someone other than their emergency contacts calls to inform you that the employee has been hospitalized.
  • When your employee has been injured at work and needs assistance returning home.
  • When your employee has not shown up to work for multiple days or shifts and you’ve been unable to contact them.
  • If the employee has passed away and you need to make the last payment or you’d like to know who to send their belongings to.

In some of the above situations, you’ll be able to ask the employee if they’d like you to call their emergency contact. If this is a possibility, always communicate with the employee first to make sure you contact the right person.

Questions You’ve Asked Us About Employee Emergency Contact Forms

Where should I store completed forms?
An employee’s emergency contact form should be kept in a safe and secure place where only those who have access to HR information have access to the form.
Should every employee fill one out?
Every employee should complete an emergency contact form. To help you keep emergency contact forms up to date, touch base with employees about the form once a year or during their performance review.
Natasha Wiebusch

Natasha Wiebusch

Natasha is a writer and former labor and employment attorney turned HR professional. Her experience as a litigator and HR trainer inspired her to begin writing about anti-discrimination laws in the workplace. As a writer at Eddy HR, she hopes to provide helpful information to both employees and HR professionals who need help navigating the vast world of human resources. When she’s not writing, you might find her cheering on the Green Bay Packers or hiking in the Northwoods of Wisconsin.

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