An employee emergency contact form is a document that is used to gather information about an employee’s medical history and emergency contact information. This is an important onboarding form that’s an integral part of maintaining employee health and safety. 

Why are employee emergency contact forms so important? 

The information collected with an employee emergency contact form can enable you to take rapid action if an emergency arises. The following examples are some of the main ways you can use these details.

To inform emergency contacts of a medical event

If an employee is injured or requires medical assistance at work, you may need to get in touch with their emergency contacts. For example, an employee may have been taken to the hospital and you might need to let their partner or next of kin know. 

To provide appropriate medical assistance

You may have employees with pre-existing medical conditions. These should be detailed in an employee emergency contact form. Things like allergy information can help you provide informed medical assistance while you’re waiting for professional help. 

To check up on an employee’s wellbeing

If an employee is unexpectedly absent from work or you can’t get in touch with them, you may want to let their emergency contacts know. It could be that there’s a completely normal reason for their absence, but it may be that they require emergency assistance. 

What information should be collected in an employee emergency contact sheet? 

An employee emergency contact form should collect basic employee information, emergency contact details, and more. 

Employee information

The form should contain basic information such as the employee’s name, address, and date of birth. Contact details are often included in case you need to get in touch with an employee in an emergency or other important situation. 

Emergency contact details

You should also collect emergency contact details for at least two trusted people in your employee’s life. Ensure you have a name, contact details, their relationship to the employee, and permission to share medical information if required. 

Additional medical information

Most emergency contact forms ask employees to provide additional medical information. This should be voluntary, but you can stress the importance of having accurate details about any medical conditions if an emergency occurs. 

Some things you can ask for here include information about pre-existing conditions or allergies to food or medication. 

When should emergency contacts be notified? 

You should always try to communicate with an employee to see if they want their emergency contacts to be notified before doing so—but this won’t always be possible. There are a few instances where you should speak with an employee’s emergency contact as soon as you can. 

  • If an employee has been injured and is unable to contact anyone themselves. 
  • If an employee has missed work for multiple days and you can’t get a hold of them. 
  • If an employee has a medical emergency and has to be taken to the hospital. 
  • If an employee has passed away and you need to send their belongings or final payment to someone. 

It’s always better to be safe than sorry. If you’re concerned about an employee and they aren’t in a position to tell you whether or not to notify an emergency contact, you probably should. 

Sample employee emergency contact form

We’ve included a sample emergency contact information form below. Make sure every employee fills one out, and store the document in a safe and secure location. Ideally, only relevant staff members will have access to this sensitive information. 

Personal Information

Name: ___________________________________________________________________

Date of Birth: ______________________________________________________________

Department: _______________________________________________________________

Home Address: ____________________________________________________________  

_________________________________________________________________________

Home Telephone: __________________________________________________________

Cell Phone Number: ________________________________________________________

Employee Emergency Contact Information

(1) Name: ________________________________________________________________

Relationship to Employee: ___________________________________________________

Home Address: ____________________________________________________________  

_________________________________________________________________________

Home Telephone: __________________________________________________________

Cell Phone: _______________________________________________________________

Work Phone: ______________________________________________________________

Can we share medical information with this contact person in the event of an emergency? (Yes/No)

 

(2) Name: ________________________________________________________________

Relationship to Employee: ___________________________________________________

Home Address: ____________________________________________________________  

_________________________________________________________________________

Home Telephone: __________________________________________________________

Cell Phone: _______________________________________________________________

Work Phone: ______________________________________________________________

Can we share medical information with this contact person in case of an emergency? (Yes/No)

Voluntary Medical Information

Please use the space below to provide as much information as possible about food allergies and existing medical conditions. This information is used to help us respond appropriately if an emergency occurs. 

Allergies: _________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Medical Conditions: _________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

 

Date: ___________________________ Signature: ____________________________ 

 

Conclusion

An employee emergency contact form is an extremely useful document that should be part of your onboarding process. It enables you to collect information about an employee’s existing medical conditions and allergies, along with emergency contact details. 

 

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