Employee Emergency Contact Form
If something happens at work, you need a name and a phone number, not a search through old email. This employee emergency contact form asks for a primary contact, a backup, and a signature so you know the details are current. It does not ask for Social Security numbers or bank details.
Last reviewed October 22, 2026 by FormSign team.
Edit it, try it, then create an account to save and share.
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Questions in this template
You
- Your name (required)
- Work email (required)
- Your phone (required)
- DepartmentOperations · Sales · Customer Support · Finance · Engineering · Other
Primary contact
- Emergency contact name (required)
- Relationship to you (required)
- Emergency contact phone (required)
- Emergency contact email
Backup contact
- Backup contact name
- Backup contact relationship
- Backup contact phone
Notes
- Anything a first responder should know?Optional. Allergies or other notes you want us to have. Do not include ID numbers.
Signature
- Signature (required)
- Date (required)
What is an employee emergency contact form?
An employee emergency contact form records who to call if an employee is hurt or unreachable. It usually includes a relationship, a phone number, and an optional note the employee wants you to have.
When to use it
- During onboarding, before the first day.
- Once a year, so phone numbers do not go stale.
- When someone changes their contact and you want a fresh signed copy.
- When you hire a group and want the same questions for everyone.
What to include
The employee
Name, work email, phone and department.
A primary contact
Name, relationship and phone. Email and address if you want them.
A backup
Someone else to try if the first person does not answer.
An optional note
Allergies or other details the employee chooses to share. Not insurance ID numbers.
A signature and date
So you can see when the record was confirmed.
Why FormSign
Every submission is a row on your board. Sort by department or by who has not finished. The starter letter prints each answer next to its question label, then a signature line, so the signed copy matches the form.
This template is a starting point, not legal advice. What you store about an employee's health depends on rules that apply to your workplace.
Questions
Should I ask for medical details?
Only what the employee wants a first responder to know. Keep it optional, and don't ask for insurance numbers or a Social Security number.
How often should people update this?
Ask again when a phone number changes, and at least once a year. The date on the form shows how current it is.
Can I send this with the rest of onboarding?
Yes. Use it on its own, or add it beside your onboarding form and handbook acknowledgment in the same workspace.
Does the employee sign it?
Yes. The last questions are a signature and a date.
Do I need an account to try it?
No. Open the template, edit it and test it. You'll create an account when you want to save it and share it.
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Start with this template
Build for free. Pay once a workflow goes live at 10 submissions or 2 documents sent for signature.