Emergency Information Form

State:
Multi-State
Control #:
US-1135BG
Format:
Word; 
Rich Text
Instant download

Description Emergency Contact Form For Employees Pdf

The information provided on this form should be used in an emergency to notify specified individual(s) of a serious illness, injury, or incident. This information should remain confidential.
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Emergency Information Sheet Other Form Names

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FAQ

Just scroll to the letter I in your phone contact list, and list your emergency ICE contact with the word ICE before their name. For example, ICE-John Smith. Then, be sure to enter every phone number (home, mobile phone and work) you have for that individual, as well as their email and physical address.

In most cases, emergency contacts are a loved one such as a parent, spouse, adult child, or trusted friend. If possible, it's best to have at least TWO emergency contacts. This way, they will be able to work together or, if one is unavailable, the other can take charge.

Names, ages and birth dates of each family member: Full names listed with date of birth and current age. Home address and telephone number: include the address of the where the list resides, include full street address, and your phone number with area code.

Name. Street Address. City, State, Zip. Phone (Home, Work) Fax No. Birth date. Blood Type. Social Security No.

In case of emergency, use iPhone to quickly call for help. With Emergency SOS, you can quickly and easily call for help and alert your emergency contacts. If you share your Medical ID, iPhone can send your medical information to emergency services when you call or text 911 or use Emergency SOS (U.S. only).

Name and address of the person. Contact details such as phone number(s) and email(s) of the person. Relationship of the employee(s) with the person. Other relevant detail(s) of the person.

If you are an adult, you put whoever you want as emergency contact. But whoever you put, make sure that they have a durable power of attorney for your health, so if you are incapacitated they can make decisions for your health treatment.

At the bottom is the Emergency Contacts section; tap add emergency contact to create a new contact. Note that you need to have this person's name and number saved in your phone's contacts list in order for the app to pull it in. Once you've selected a contact, indicate their relationship to you.

An emergency contact is the first person medical personnel will get in touch with in an emergency, but your emergency contact may not have the legal authority to act on your behalf unless you explicitly provide that power.Ideally, you will name the same person to be your agent and your emergency contact.

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Emergency Information Form