New Starter Checklist
Get somebody started properly, with the checks, paperwork, safety induction and equipment handled as a list rather than remembered in pieces.
SR-06 1 page
Staff records · SR-13
Employee Emergency Contact Form
A free printable emergency contact form — two contacts, how to reach them, and anything the employee wants responders told.
Download Free · no sign-up
One page. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.
Print it and write on it
Fill it in type and save
The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.
What this sheet is for
Have somebody to telephone when something happens at work, before you need it.
Who it is for
Every employer, and particularly small ones who assume they would just know.
How to use it
- Ask every employee to complete one when they start.
- Take two contacts. One is often unreachable.
- Only record medical information the employee volunteers.
- Store securely and review once a year.
- Make sure whoever would need it can actually get to it out of hours.
What is on the sheet
One page, top to bottom:
Printed under the title: Who to telephone if something happens to a member of staff at work.
Personal data — hold it carefully. Hold this securely and no more widely than necessary — it is personal data about an employee and about somebody who is not your employee at all. Ask before recording anything medical, keep it to what is needed in an emergency, and review it once a year.
Write-on lines: Employer · Department · Form completed
The employee
Write-on lines: Name · Job title · Staff number · Home address · Personal phone
First contact
Write-on lines: Name · Relationship · Phone, daytime · Phone, other · Address if different
Second contact
Write-on lines: Name · Relationship · Phone, daytime · Phone, other
Anything responders should be told
Ruled lines: Only what the employee is content to share
Signature strip: Employee · Received by · Date
Questions
Is it safe to keep this on paper?
It holds other people's personal details, so keep it somewhere secure, show it to no more people than need it, and destroy it once there is no longer a reason to hold it. Data protection law applies to a sheet of paper exactly as it does to a database.
Can I ask about medical conditions?
Be careful. What you may ask, and what you must do with the answer, is governed by employment and data protection law where you are. This form asks only for what the employee is content to share, and you should not press beyond that.
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