Employee 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.
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.
22 questions · about 3 min · logic · signature · prefill from the link
- No sign-up to start
- Unlimited responses on Free
Print it as a PDF Word version
Change the questions in Word, then print.
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
- +13125550148
- First contact’s name
- Wiremu Ngata
- Their relationship to you
- Spouse or partner
- First contact’s mobile
- +13125550193
and 11 more answers
| submitted_at | Your name | Department or team | Your mobile number | First contact’s name | Their relationship to you |
|---|---|---|---|---|---|
| 23 Sep 2026 09:41 | Aroha Ngata | Warehouse | +13125550148 | Wiremu Ngata | Spouse or partner |
Export to CSV or Excel, or send responses to Google Sheets, Notion, Airtable, Slack or a webhook. All free.
What happens after someone submits
A contact list only helps if it is current, so each update reaches HR the day it is sent.
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Submitted
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Someone sends their contacts
HR gets an email with the contacts and any health note, so the list is right the same day.
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At the same time
Responses go to Google Sheets as dated rows, ready for HR to open in an emergency.
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They send an update later
Their People record keeps every version they have sent, filed under their work email.
What this form asks, and why
The last column shows how often real emergency contact forms ask for it.
| 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 a responder which supervisor to call. | 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 |
| Your work email | Optional; on 10 of 30 forms. Files each update under the right person. | 10 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 them and a promise to report changes, in one checkbox. | 6 of 30 forms |
| Signature | Optional. On 19 of 30 forms, but the checkbox and the 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
How often each field appears, from forms organizations use today. Part of the Form Field Index.
Read September 2026 · US 20, UK 5, Canada 4, Australia 1 · Sources
- 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.
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When “Add a second contact?” is Yes
shows “Second emergency contact”
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When “Add a third contact?” is Yes
shows “Third emergency contact”
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When “Would you need help to leave the building in an emergency?” is Yes
shows “What help would you need?”
Make it yours
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Give each team its own link
Add ?dept=Warehouse to the link and the department is filled in, so responses sort by team.
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Keep it to staff
Turn on Password protection in Settings → Access and limits, and share the password on your intranet.
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Name who reads it
Name the people who open it in an emergency in the note, if they are not HR and your manager.
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
How often should staff update their emergency contacts?
Whenever one changes: the thank-you screen asks people to send the form again, and HR uses the newest. To check everyone, send the link once a year.
Can an employee decline to give an emergency contact?
10 of 30 forms say giving the details is voluntary. To allow it, turn off 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. UK employers usually ask for next of kin: pick “Next of kin (UK)” above the preview.
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?
Not quite the job? One of these may fit, or browse all HR and employee forms.
- New employee information form
For a new starter’s own details: legal name, address, start date and job.
- Workplace incident report
For recording what happened after someone is hurt at work.
- Day camp enrollment form
For enrolling a child in a camp, with pick-up people and medication too.
Start with the emergency contact form template
Open it in the editor, add your organization’s name and send the link with your onboarding pack.
By Michael Hodge, founder of PulseFormCreator. Updated 23 Sep 2026.