Emergency contact form template
Collect the people to call if an employee is hurt, falls ill or does not turn up: up to three contacts, how to reach them, and anything a first aider should know.
21 questions · about 3 min · logic · e-signature · prefill from the link
- No sign-up to start
- Unlimited responses on Free
Your name
Department or team
Your mobile number
First emergency contact
The person we call first.
First contact’s name
Their relationship to you
First contact’s mobile
Another number for them (home or work)
Add a second contact?
Someone to call if the first person does not answer.
What you get back
Every response lands in your results the moment it is sent. Turn on email notifications and each one arrives like this, and the same answers become a row in your spreadsheet.
From PulseFormCreator
Subject New response to Emergency contacts
- Your name
- Aroha Ngata
- Department or team
- Warehouse
- Your mobile number
- +61412555048
- First contact’s name
- Wiremu Ngata
- Their relationship to you
- Spouse or partner
- First contact’s mobile
- +61412555193
and 10 more answers
| submitted_at | Your name | Department or team | Your mobile number | First contact’s name | Their relationship to you |
|---|---|---|---|---|---|
| 2026-09-22T09:41:00.000Z | Aroha Ngata | Warehouse | +61412555048 | Wiremu Ngata | Spouse or partner |
The first 6 of 30 columns. Export to CSV or Excel, or send each response to Google Sheets, Notion, Airtable, Slack or a webhook as it arrives, all on the free plan. The answers above are made up.
What this form asks, and why
The last column shows how many of the 30 real emergency contact forms we read ask the same thing.
| Question | Why it is there | Real forms |
|---|---|---|
| Your name Required | Whose contacts these are, asked on 30 of 30 forms. | 30 of 30 forms |
| Department or team | Optional. Tells whoever responds which supervisor to bring in. | 8 of 30 forms |
| Your mobile number Required | HR tries you first, including when you have not turned up. | 20 of 30 forms |
| First contact’s name Required | The person to call. | 30 of 30 forms |
| Their relationship to you Required | The caller needs to know who they are speaking to. 25 of 30 forms ask. | 25 of 30 forms |
| First contact’s mobile Required | The number most likely to be answered. | 30 of 30 forms |
| Another number for them (home or work) | Optional fallback: 20 of 30 forms ask for more than one number. | 20 of 30 forms |
| Add a second contact? | 25 of 30 forms leave room for two. People with one contact skip the next section. | 25 of 30 forms |
| Second contact’s name Required | Called when the first person does not answer. | 25 of 30 forms |
| Second contact’s relationship to you Required | The same list, so the export lines up. | 25 of 30 forms |
| Second contact’s mobile Required | Required once a second contact is added. | 25 of 30 forms |
| Add a third contact? | Shown after a second contact. 6 of 30 forms leave room for three. | 6 of 30 forms |
| Third contact’s name Required | For people whose first two contacts are hard to reach. | 6 of 30 forms |
| Third contact’s relationship to you Required | As above. | 25 of 30 forms |
| Third contact’s mobile Required | Contacts are called in order until someone answers. | 6 of 30 forms |
| Anything a first aider or paramedic should know | Optional: one box a paramedic can read. 8 of 30 forms ask about conditions. | 8 of 30 forms |
| Would you need help to leave the building in an emergency? | Puts you in the evacuation plan. Only 1 of 30 forms asks it. | 1 of 30 forms |
| What help would you need? Only when “Would you need help to leave the building in an emergency?” is Yes | Shown after Yes, for the building’s emergency coordinator. | 1 of 30 forms |
| Do the people you listed know they are your emergency contacts? | Our addition: a contact who expects the call picks up. | Our own recommendation |
| Agreement Required | Permission to call these people and a promise to report changes, in one tick. | 6 of 30 forms |
| Signature | Optional. On 19 of 30 forms, but the tick and the submission time already record agreement. | 19 of 30 forms |
What we left out
- Social Security or other ID numbers. 3 of 30 forms ask for one. Nobody needs an ID number to phone someone.
- The contact’s home address. 17 of 30 forms ask. A caller phones, and the address belongs to someone who never saw the form.
- The contact’s employer. Still on 4 of 30 forms, from before mobile phones.
What 30 real emergency contact forms ask
In September 2026 we read 30 emergency contact forms that organisations use today (US 20, UK 5, Canada 4, Australia 1) and recorded every field. This is how often each one appears. It is part of the Form Field Index.
The 30 forms we read
- Federal Retirement Thrift Investment Board · federal agency, US
- University of Utah, Department of Materials Science and Engineering · university department, US
- Associated Students, San Diego State University · university student association (employer), US
- LaSalle County, Illinois · county government, US
- Town of Emerald Isle, North Carolina · town government, US
- Morrow County, Ohio · county government, US
- Guildford Borough Council · local council, UK
- South Central Ambulance Service NHS Foundation Trust · NHS trust, UK
- Epping Scaffolding · small business (construction), UK
- Elizabethtown College · college, US
- University of Leeds · university, UK
- Research Foundation for SUNY at the University at Buffalo · university research foundation, US
- Greencastle-Antrim School District · school district, US
- Swansea University · university, UK
- BC Public Service (Government of British Columbia) · provincial government, Canada
- DC Department of Parks and Recreation · city parks department (summer camp), US
- Morrisville School District · school district, US
- Town of Richmond, Massachusetts · town government, US
- Macomb Community College · community college, US
- City of Rockledge, Florida · city government, US
- Gooding Joint School District #231 · school district, US
- Washington State Department of Enterprise Services · state agency, US
- USDA National Finance Center (form NFC-492) · federal agency, US
- New Jersey Institute of Technology · university, US
- Cranberry Township, Pennsylvania · township government, US
- The Royal Children's Hospital Melbourne · hospital (students on placement), Australia
- New York City Department of Education · school district, US
- Government of Saskatchewan (Public Service Commission) · provincial government, Canada
- Sudbury Catholic District School Board · school board, Canada
- Community Living British Columbia · provincial crown agency, Canada
How the form changes as people answer
Most people see a shorter form. These questions and screens only appear when an answer calls for them.
-
When “Add a second contact?” is Yes
shows “Second emergency contact”
-
When “Add a third contact?” is Yes
shows “Third emergency contact”
-
When “Would you need help to leave the building in an emergency?” is Yes
shows “What help would you need?”
Make it yours
-
Give each team its own link
Add ?dept=Warehouse to the link and the department is filled in, so responses sort by team.
-
Keep it to staff
Turn on Settings → Password protection and share the password on your intranet.
-
Keep one list HR can reach
Connect Google Sheets in the Connect tab. Each submission becomes a dated row; the newest per person is current.
Good practice and the law
This is general information, not legal advice. Rules differ by country and state, so check anything important where you operate.
- US
Employers may ask who needs help to evacuate, if they say it is voluntary and share answers only with people who have duties under the evacuation plan. EEOC, emergency evacuation procedures
- UK
Employers must take all reasonable steps to keep workers’ details accurate, and should consider checking them from time to time. ICO, keeping employment records
- Australia
A private employer’s records about current and former staff are exempt from the Privacy Act 1988; applicants’ records are not. OAIC, employment
Questions about this template
Can an employee decline to give an emergency contact?
Many employers allow it: 10 of 30 forms say giving the details is voluntary. If you do, untick Required on the first contact’s questions.
Is next of kin the same as an emergency contact?
No. Next of kin is your closest relative; an emergency contact is whoever should be called. Every UK form we read asks for next of kin: pick “Next of kin (UK)” above the preview.
Where should completed emergency contact forms be kept?
Apart from the personnel file, within reach of whoever responds. A CSV or Excel export gives you an offline copy.
Can a school use it for students?
Yes. “Student or participant” adds date of birth, two parents or guardians, and whether each contact may collect the child.
Which form do you need?
The emergency contact form is one of the hr & employee forms. If it is not quite the job, one of these may be.
- Employee information form template
For a new starter’s own details for the HR file: legal name, address, start date and job.
- Incident report form template
For recording what happened after someone is hurt at work.
- Summer camp registration form template
For enrolling a child in a camp, with pick-up people and medication as well as contacts.
Start with the emergency contact form template
Open it in the editor, add your organisation’s name and send the link with your onboarding pack.
Updated 22 September 2026. Evidence read September 2026 from 30 real forms.