Classic form

Emergency contact form

The emergency contact on file is usually the one somebody typed on their first day, three phone numbers ago. This form exists to be resent every year without asking anybody to confirm their bank details again, and it asks two questions most versions leave out: how much may be disclosed, and whether anybody must not be contacted. It is a classic form, because a first aider reading it needs the whole record on one page.

Create a form with OneCraft16 fields, 12 required

Welcome screen of the emergency contact form example — The welcome screen respondents see first. The image was generated for this example.

The form itself

A static copy of the finished form, exactly as it renders. Nothing here can be filled in or submitted, so read it as a reference and build your own from the button above.

Emergency contact details

Reviewed every March and whenever anything changes. Kept by the people team, opened only by a manager or a first aider, and used for one thing: reaching somebody who matters to you on a day that has gone wrong.

You

Your name *

First

Last

Employee number *

Where you work *

Your mobile *

The person we ring first

One person, the one who would actually answer. Not the person you feel you ought to name. A parent two states away who screens unknown numbers is a worse first contact than a neighbour who is home at three in the afternoon.

Their name *

First

Last

Their relationship to you *

Best number for them *

A second number for them

Do they know you have listed them? *

Yes

Not yet, and I will tell them this week

Do they live with you? *

Yes

No, but they are nearby

No, they are more than an hour away

Two people we would try next

First contacts are in meetings, on planes and in the shower. Two backups is the number that has always been enough, and a first name with a mobile is a complete answer here.

Backup contacts

#	Name	Relationship	Mobile	Do they know?
1
2

Anything a first aider should know

This box is optional and it is not a medical record. It exists so somebody kneeling next to you is not guessing. Write the one or two things that would change what they do, and nothing else. It is visible to the first aid team and the people team, and to nobody in your line of management.

What would help somebody helping you

Two things people rarely get asked

If something happens at work, can we tell your contact what has happened and where you are? *

Yes, tell them everything you know

Tell them I am unwell and where I am, and nothing more

Ring them but say only that they should come

The next question is asked because for some people it is the most important line on the form. Anybody named here is never rung, never told where you work, and never given information about you. It is read by two people in the people team and it is not discussed with your manager unless you ask for that.

Is there anybody who must not be contacted about you? *

Yes, and I have written their name below

If yes, who

Confirm

I confirm *

These numbers are current and I have checked at least the first one

I authorise my employer to contact the people named above in an emergency when I cannot be reached

I understand this replaces whatever emergency contact was on file for me

I will send this form again rather than telling one person, if any of it changes

Every field, and what it collects

The complete field list, in the order respondents meet it.

Your nameNameRequired
Employee numberShort textRequired
Where you workDropdownRequired: Options: Ardenway House · Bell Meadow · Community nursing, north · Community nursing, south · Head office
Your mobileShort textRequired
Their nameNameRequired
Their relationship to youDropdownRequired: Options: Partner or spouse · Parent · Adult child · Sibling · Friend · Neighbour · Housemate · Someone else
Best number for themShort textRequired
A second number for themShort text
Do they know you have listed them?Single choiceRequired: Options: Yes · Not yet, and I will tell them this week
Do they live with you?Single choiceRequired: Options: Yes · No, but they are nearby · No, they are more than an hour away
Backup contactsTable: Columns: Name · Relationship · Mobile · Do they know?
What would help somebody helping youLong text
If something happens at work, can we tell your contact what has happened and where you are?Single choiceRequired: Options: Yes, tell them everything you know · Tell them I am unwell and where I am, and nothing more · Ring them but say only that they should come
Is there anybody who must not be contacted about you?Single choiceRequired: Options: No · Yes, and I have written their name below
If yes, whoLong text
I confirmMultiple choiceRequired: Options: These numbers are current and I have checked at least the first one · I authorise my employer to contact the people named above in an emergency when I cannot be reached · I understand this replaces whatever emergency contact was on file for me · I will send this form again rather than telling one person, if any of it changes

What makes this form work

It asks how much may be said, not just who to ring

Three options, from tell them everything to say only that they should come. It costs one field and it settles the hardest thirty seconds of an emergency call, which otherwise falls to whoever happens to be holding the phone.

The do not contact question is asked plainly and answered privately

A name is enough and no explanation is invited. The paragraph above it says who reads the answer and that it is not shared with a line manager. For a minority of staff this is the single most important line on any form their employer holds.

It says out loud that the first contact should be reachable

Naming the person who would actually answer, rather than the person you feel you ought to name, is the difference between a contact list and a working one. The prompt is one sentence and it changes what a surprising number of people write.

Questions people ask

Why keep the emergency contact on a form of its own?

Because it is the only staff detail that goes out of date quietly and the only one somebody needs at speed. A short form can be resent every March and answered in three minutes. Folded into a fifteen minute onboarding form it gets filled in once, by somebody who has not yet moved house, and never looked at again.

How many emergency contacts should you ask for?

One properly, then two in outline. The first contact is worth six fields because that is the call that gets made. Backups only need a name, a relationship and a mobile, which is why they sit in a small table rather than repeating the whole block twice.

Should a form ask about health conditions?

Only what changes what a first aider does, only optionally, and with the audience named at the field. This one says who reads it and who does not, and gives concrete examples so people write "EpiPen in my bag" instead of a diagnosis. It is not a medical record and the form says so rather than implying otherwise.

Who should be able to open these answers?

Not everybody with the link. A form holding home numbers and a do not contact name should be published with login required and an allow list, or behind a secret key sent to staff, both of which are access settings on the form rather than anything you build. Responses are visible to whoever can open the form in the builder.

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Want the steps in the builder? Read Control who can fill in your form, then View, export and manage your responses. For everything this generator can do, see the form maker.