US Legal Forms
Emergency Information Form

Emergency Information Form

Name: Emergency Information Form
Brand: US Legal Forms
Price: 59.00 USD
Rating: 4.74 (205 reviews)

Category:

Employment - Personnel Files

State:

Multi-State

Control #:

US-1135BG

Format:

Instant download

Description Emergency Information Form Printable

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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Employer Emergency Contact Form Form Rating

4.74

Satisfied(205)

Form popularity

FAQ

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.

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.

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.

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.

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

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.

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.

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.

Emergency Information Form

Description Emergency Information Form Printable