Emergency Contact Form
Who to call, in what order, and what they need to know.
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| Name | [name] |
| Date of birth | — |
| Address | [address] |
Contacts, in order
| Name | Relationship | Phone |
|---|---|---|
| [add one contact per line] |
What is an Emergency Contact Form?
An emergency contact form lists who to call, in what order, and what they need to know. It is a document whose whole value is being findable and current at a moment when nobody has time to look for it.
Schools, employers, clubs and childcare all collect one, and the same problems recur: a single contact who cannot be reached, a number that changed two years ago, and medical information that was left off because the form did not ask clearly.
Order matters more than length. Three contacts listed in the order they should be tried, each with a relationship and a number that will be answered during the relevant hours, beats six names in no particular sequence.
The form holds sensitive information — a medical condition, a home address, a child's details. Store it where it can be reached quickly by the people who need it and not by anyone else, and destroy old copies rather than leaving them in a drawer.
What to put in an Emergency Contact Form
These are the details this template asks for. Anything left blank is marked in red on the preview so you can see what is still missing.
| Field | What goes in it |
|---|---|
| This form is for | For example: Micah Romero |
| Date of birth optional | Free text |
| Home address | For example: 588 Kinnear Road |
| Emergency contacts, in order | One per line: Name | Relationship | Phone |
| Medical information optional | One per line |
| Doctor optional | For example: Dr. Halbrook, Kinnear Family Practice — (614) 555-0288 |
| Insurance or reference optional | For example: Policy 4471-889 |
How to write an Emergency Contact Form
Identify the person the form is about
Full name, date of birth where relevant, and home address. For a child, add the class or group so staff can match the form to the right person quickly.
List contacts in the order they should be tried
Name, relationship and phone number. Put the person most likely to answer during the day first, not the person most senior in the family.
Include at least one contact outside the household
A neighbour, a relative nearby, a family friend. If the household is unreachable — travelling, in the same incident — the whole list fails without one.
Record medical information plainly
Conditions, allergies, medication and where it is kept. Write what someone would need to act on, in words a non-medical person can follow.
Date it and set a review
Put the date on the form and check it every year, or whenever a number changes. An out-of-date emergency form is worse than none, because people rely on it.
Common mistakes
- One contact only, and no alternative if they do not answer.
- Every contact living in the same house.
- Leaving out an allergy or medication because the form did not ask directly.
- Never updating it after a phone number or address changes.
- Keeping copies in several places so nobody knows which is current.
Frequently asked questions
How many emergency contacts should I list?
Two or three, in order, with at least one who does not live with the person. More than that and nobody gets past the first two anyway.
Should the form include medical information?
Include what someone would need to act on in an emergency — allergies, conditions, medication and where it is kept. Anything beyond that belongs with a doctor, not on a form held in an office.
Who should be able to see this form?
The people who would use it in an emergency, and no wider. It holds personal and often health information, so it should be stored securely and not left on a shared desk or drive.
How often should it be updated?
At least once a year, and immediately when a number, address or medical detail changes.
Can an emergency contact consent to medical treatment?
Usually not, unless they hold specific legal authority. In an emergency, clinicians act on their own judgement. Check what your organisation's policy says about who may be asked.
This page explains general practice and is not legal advice. Requirements differ between countries and, in some cases, between states — check what applies where the document will be used.