Emergency information form template

About this emergency information form

An emergency information sheet keeps everything a family, babysitter or neighbour would need in a crisis on one page: each family member with key medical facts, emergency contacts, doctors and hospital, where to meet if you must leave home, where the water, gas and electricity shut-offs are, and important numbers.

Fill it in together as a family, put it on the fridge and keep a photo on each phone.

What’s on the emergency information form

The template has 6 sections and 16 questions. Every one can be renamed, moved or deleted.

• Home: Address; Nearest landmark; Home phone
• Family members: Family table (Name, Date of birth, Blood group, Medical needs or allergies, Mobile)
• Emergency contacts: Contacts table (Name, Relationship, Phone)
• Medical: Family doctor and phone; Nearest hospital and phone; Pharmacy and phone; Health insurance and policy number
• Emergency plan: Meeting point near home; Meeting point away from home; Water shut-off location; Gas shut-off location; Electricity main switch location; First aid kit kept at
• Important numbers: Numbers table (Service, Number)

Tips

• Agree two meeting points: one just outside the house, one further away.
• Show older children where the shut-offs are.
• Review it every year, or after a move.

Four ways to save it

A fillable PDF has typing boxes, tick boxes and choices built in. A printable PDF gives clean boxes and writing lines for pen and paper. The Word file can be edited further, and the HTML code adds the same questions to a website. Browse more form templates, or design a completely different layout in the custom form builder.