Prepare printable emergency contact forms that employees complete by hand or you fill in and download on your own device. Up to three contacts, write-in lines for blank fields, and nothing is uploaded.
WHO TO CALLNo account needed
Fill in the form on this device, or choose Start blank to print a form for an employee to complete by hand. Empty fields print as write-in lines. Your draft stays in this tab if you refresh; nothing is uploaded or sent.
Step 1 of 3Employee details
Every field is optional. Leave any field empty to print a line for writing in by hand.
Step 2 of 3Emergency contacts
List up to three people to contact, in the order to try them. A contact with any details needs a name, and a named contact needs at least one phone number. Leave a section empty to print it blank.
Primary contact
This is already the primary contact.
Second contact
This is already the last contact.
Step 3 of 3Optional details and privacy
This box is voluntary. The employee decides whether to add anything, such as a preferred name or a language their contacts speak. Do not ask employees to list medical conditions; leave it empty to print lines they can use or leave blank.
Keeping completed forms private
Completed forms contain personal information. Store them securely, limit access to the people who need them in an emergency, and ask employees to update the form when their details change. Rules on keeping employee records vary by place, and this tool is not legal advice.
Information the employee chooses to share for an emergency (optional)
Prefers to be called Jo. Alex speaks English and Spanish.
Employee signatureDate
Confidential: this form contains personal information. Keep completed forms secure, share them only with people who need them in an emergency, and replace the form when details change.
Know who to call if an employee is hurt or taken ill at work. This free employee emergency contact form records the employee's details and up to three contacts in the order to try them, then prints or downloads as text and CSV. Fill it in on your own device, or start blank and print a form for each employee to complete by hand. The editable sample is filled in for a fictional employee, Jordan Lee.
Make an emergency contact form for employees
Add the form title and, if you like, the business name.
Enter the employee's name, role or department, phone, home address and the date completed. Leave any of these empty to print a line for writing in.
Add up to three emergency contacts with their relationship, phone, another phone, email and the best time to call. A contact with any details needs a name, and a named contact needs at least one phone number.
Use the arrows to put the contacts in the order to try them. The first is printed as the primary contact.
If the employee wants to, add anything they choose to share for an emergency, such as a preferred name or a language their contacts speak.
Check the preview, then print the form or download a copy.
Use Start blank for a fill-in form with two empty contact sections, or Reset sample to see the example again. The page asks before replacing your current draft.
An emergency contact form template for employees to fill in by hand
Every field on this emergency contact form template for employees is optional, so a blank form prints cleanly: each empty field becomes a ruled line, with space at the end for the employee's signature and date. Print one copy per employee, or fill in the parts you already know, such as the business name and role, and leave the rest to them.
Ask for details at the start of employment as part of the onboarding checklist, and ask again once a year or when someone tells you they have moved or changed phone. A form with an old phone number does not help when it is needed. When someone leaves, the offboarding checklist is a good place to note that their form should be removed from your records.
Keep the optional box voluntary. It is for what the employee decides to share, not a health questionnaire, so do not ask employees to list medical conditions on this form. Leave the box empty if they have nothing to add.
Keep completed forms private
A completed form contains personal information about the employee and about people who do not work for you. Store paper copies somewhere locked, keep digital copies where only the people who need them can open them, and replace a form when details change rather than crossing out old numbers. Rules on keeping employee records vary by place, and this page is not legal advice.
Print / PDF opens the browser's print dialog, where you can choose a printer or save a PDF. The printed form ends with a short confidentiality note. The text download writes empty fields as lines; the CSV has one row per contact, each with the employee's details, for a spreadsheet you keep securely.
The draft is kept in this browser tab when browser storage is available, and nothing you type is uploaded or sent. Download or print a copy before closing the tab or replacing the draft.
Frequently asked questions
Can I make an employee emergency contact form without an account?
Yes. The form opens with a fictional example and works without a login or email address. Everything stays on your device.
How many emergency contacts should an employee list?
The form holds up to three. Two give you a second person to call if the first does not answer; add a third if the employee wants to.
Should the form ask about medical conditions?
This form does not ask for medical details. The optional box lets the employee share only what they choose for an emergency, and it can stay empty.
Where should completed forms be kept?
Somewhere secure that the people responsible in an emergency can reach quickly, such as a locked file or an access-restricted folder. Keep the employee's availability form and the staff rota separate, since those are shared more widely.