Allegheny Pennsylvania Sample Letter for Personnel Emergency Record Form Dear [Employee's Name], In order to ensure the safety and well-being of all employees, the [Company/Organization Name] requires the completion of the personnel emergency record form. This form is designed to provide us with critical information about potential emergencies and enable us to respond swiftly and appropriately in case of any unforeseen circumstances. The Allegheny Pennsylvania Sample Letter for Personnel Emergency Record Form comprises different sections to collect essential details. These sections include: 1. Personal Information: — EmployefunnymaAdamam— - Address - Phone number(s) — Email address 2. Emergency Contact Details: — Name of the primary emergency contact person — Relationship to themployedye— - Phone number(s) 3. Medical Information: — Existing medical conditions, if an— - Allergies and corresponding reactions — Current medicationsapplicablebl— - Special medical equipment required, if any 4. Emergency Evacuation Plan: — Any mobility limitations or impairments — Preferred evacuation method (e.g., elevator, stairs) — Assistance required for evacuation, if any 5. Special Instructions: — Any specific instructions or considerations during an emergency (e.g., medical protocols, personal preferences) It is imperative that you complete this form accurately and update it promptly whenever there are any changes to your personal or emergency contact information. This will enable us to reach out to you or your emergency contact efficiently and ensure your safety during any emergencies or incidents that may arise. Rest assured that the information provided will be treated with utmost confidentiality and will only be shared with authorized personnel involved in your safety and emergency response. Please return the completed form to the HR Department no later than [deadline date] to ensure we have your updated and accurate emergency record on file. Your cooperation in completing this form is greatly appreciated, as it will significantly contribute to maintaining a safe and secure work environment for all employees. If you have any questions or require assistance in filling out the form, please do not hesitate to contact [HR contact person] at [HR contact number/email]. Thank you for your prompt attention to this matter. Sincerely, [Your Name] [Your Position] [Company/Organization Name]