What Is It?
An Employee Emergency Contact Form is a document used by employers to gather important contact information of an employee's designated emergency contacts. The form helps ensure that the necessary information is readily available and can be quickly accessed in the event of an emergency.
When To Use It?
An Employee Emergency Contact Form is typically used:
- During the hiring process: The form can be part of the new hire paperwork and should be completed by the employee before their first day on the job.
- In case of an emergency: Should there be an emergency involving the employee, the employer will use the information on the form to reach the designated emergency contact.
- For updated contact information: Employees may change their emergency contact information over time, so it's important to regularly update the form.
Having a completed and updated Employee Emergency Contact Form is crucial for ensuring the safety and well-being of employees in emergency situations.
What To Include?
An Employee Emergency Contact Form typically includes the following information:
- Employee Information: This includes the employee's name, job title, and contact information.
- Emergency Contact Information: The name, relationship, and phone numbers of at least two designated emergency contacts.
- Additional Information: Any additional information that the employer may find useful in an emergency situation, such as the employee's medical contact information
It's important to note that the information included in the Employee Emergency Contact Form should be kept confidential and only used for emergency purposes. Employers should also have policies in place to protect the privacy of this information.
Emergency Contact Information |
Employee’s Full Name |
|
Position |
|
Department |
|
Supervisor/ Manager |
|
Employee ID |
|
Emergency Contact Name |
|
Contact Phone Number: |
|
Alternate Phone Number |
|
Contact Address |
|
|
Medical Contact Information |
Primary Care Physician Name |
|
Primary Care Physician Phone Number |
|
Insurance Provider Name |
|
Insurance Policy Number |
|
Allergies (if any) |
|
Current Medications (if any) |
|
|
Signature of Employee: |
|
Date: |
|