Employee Medical Emergency Information Record Form

Employee medical emergency information record form is used in an emergency situation when an employee of any organization needs any kind of medical help. This form contains all necessary information related to that particular employee.

Employee emergency information form mainly contains three sections i.e. personal information, medical information and emergency information. In personal information section, all the basic information of the employee ( employee ID, Name, Gender, Citizenship, place of birth, home address, district or country, home phone, cell phone, email address, date of birth, national tax number, passport number and driving license) is mentioned. This personal information is helpful in identifying the employee in case of an emergency.

The second section of the form consists of medical information that includes employee’s doctor’s name, doctor’s address and contact number, employee blood group, medical conditions, allergies and current medications. This medical information is helpful in assessing the medical condition of the employee in an emergency situation as employee emergency contact.


The third and last section of this form consists of emergency information that includes emergency contact’s name, relationship with the employee, address and contact number of that person.

The form is considered to be a very useful tool for developing individual employee emergency response information. According to law, there is no binding on specific things to add in this information form. Employers are not bound to include specific information about the employees but flexibility is given to employers to collect such information that is useful for employees in case of emergencies. However, emergency information should be different for employees having disabilities.

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Employee Medical Emergency Information Record Form


Simi Karton

Simi Karton is a regular contributor to National Science Quarterly and an enthusiastic Lakers fan. She recently collaborated on a manuscript with friends and colleagues. Dr. Simi Karton, entitled Parkinsons and the Genetic Response to Eastern Medicine, in which she and Dr. Inshal presented research compiled during a summer spent in United States. She currently resides in Los Angeles with her husband. This website is a voluntary work of Dr. Karton to provide people with useful health related information stuff at an easy approach. The information has been collected from different sources at one place.

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