---
title: Emergency contact form template, free
description: A free emergency contact form template. Who to call in an emergency: two contacts, how they are related and the best way to reach them. Publish it as one link; every response is its own signed copy.
---

# Emergency contact

Who to call in an emergency: two contacts, how they are related and the best way to reach them.

Keep up-to-date emergency contacts, confirmed by the person they belong to.

## About you

- Full name (text)
- Email (email)
- Phone (phone, optional)

## First contact

- First contact name (text)
- Relationship (text)
- Mobile phone (phone)
- Other phone (phone, optional)
- Email (email, optional)

## Second contact

- Second contact name (text, optional)
- Relationship (text, optional)
- Phone (phone, optional)

## Anything else

- Preferred language (text, optional)
- Note (text, optional)
- My contacts know that I have given their details for this purpose. (tick box)

## Signature

- Person signature (signature)
- Person date signed (date signed)