Emergency Contact List

Posted on
December 15, 2015 by

Family Emergency Contact List

 

Access to family information is critical in times of stress. In an emergency, there is not time to go hunting for phone numbers, addresses, insurance policies, etc. in times of crisis. This template will help you get the bulk of that emergency contact information in one place.

NOTE: Once you have filled in this information, it is important for you to take the following steps:

    • Lock this information away in a safe & secure place that is easy for you to get to in times of emergency. You may also want to keep a copy at your workplace or with another family member.
    • Review and update this document a few times a year, as information can rapidly become outdated

 


Section 1: Contact Data for Family Members

Parent / Guardian Name 1: 


Company / Employer:


Work Address:


Work Phone:


Cell Phone:


Parent / Guardian Name 2: 


Company / Employer:


Work Address:


Work Phone:


Cell Phone:


Child Name:


Work Phone #


Home / Cell Phone:


Child Name:


Home / Cell Phone:


Work Phone #:


Child Name:  


Home / Cell Phone:


Work Phone #:


Section 2: School Information

Child Name: 


School Name:


School Address:


Main Phone:


Child Name: 


School Name:


School Address:


Main Phone:


Child Name: 


School Name:


School Address:


Main Phone:


Questions to ask your child’s school:
Will the school hold or release your child in an emergency situation?
Where will the school move your child in an emergency situation?
How will the school communicate with families during a crisis?
Does the school store enough food, water and other basic supplies?
Is there a disaster plan in effect, or any disaster policies that you need to be aware of (i.e. emergency pick up plan)?

Section 3: Medical Information

Insurance Co. Name:


Policy Number:


Phone:


Family Doctor:


Family Doctor’s Phone:


Closest Hospital:


Closest Hospital Address:


Hospital Phone:


 

Section 4: Social Security (U.S.)/ Social Insurance (CDN)#

Name:
SSN/ SIN # :


Name:
SSN/ SIN # :


Name
SSN/ SIN #:


Name:
SSN/ SIN #:


Name:
SSN/ SIN #: