Give us the details of who to contact in an emergency.
HR template · 12 fields (8 required) · ~3 min for respondents to complete · Free plan · No credit card · Fully customizable
Set up your employee emergency contact form template
Give us the details of who to contact in an emergency.
Ask employees to update this yearly or whenever details change. Store responses with restricted HR access and use them only in an emergency.
The form separates your phone number, department and job title, primary contact name, primary contact relationship into labeled questions. Review the choices and required fields for your organization before sharing it.
Best practices
Ask employees to update this yearly or whenever details change. Store responses with restricted HR access and use them only in an emergency.
Customize the your phone number and department and job title questions to match your records and terminology.
Name the team that reviews responses and explain what happens after submission. A requested date, service or approval is not automatically confirmed.
Ask only for information needed for this step. Arrange any sensitive supporting documents through an appropriate private process.
Every field, explained
Employee full name (Name, required)
Work email (Email, required)
Your phone number (Phone, required)
Department and job title (Short text, required)
Primary contact name (Short text, required)
Primary contact relationship (Short text, required) — For example spouse, parent, sibling or friend.
Medical information responders should know (optional) (Long text) — For example severe allergies; share only what you are comfortable with
Confirmation (Multiple choice, required)
Frequently asked questions
What does this employee emergency contact form template template collect?
Alongside contact details, it asks for your phone number, department and job title, primary contact name, primary contact relationship, primary contact phone, secondary contact name (optional), secondary contact relationship (optional), secondary contact phone (optional), medical information responders should know (optional), confirmation. You can rename questions, change choices and remove fields that your workflow does not need.
How should I use this employee emergency contact form template form?
Ask employees to update this yearly or whenever details change. Store responses with restricted HR access and use them only in an emergency.
Can I edit this form and print a copy?
Yes. Open an editable draft, adjust the questions, and review the preview before publishing. You can also use the template page’s print option. Publishing requires an account; the draft can be tried first.