Provide this form to employees to gather useful emergency contact and medical/health information in the event of an emergency situation.
Note: This information can be collected and stored on paper or collected and stored electronically. If you store the information electronically ensure you have a system or back up system that can be accessed in an emergency situation. You might consider having a paper version onsite, secularly maintained but accessible in the event of an emergency. Make note of the existence of this information in your emergency preparedness procedures.