An emergency contact form gathers phone numbers to call in case of an emergency. Whether you’re an employer or a physician, use this free Emergency Contact Form to quickly gather emergency contact information online. Simply customize the form with our Form Builder, and email it to employees or have patients fill it out on a mobile device during their visits. You’ll instantly receive submissions in your Jotform account, easily accessible on any device and ready to download or print for your records.
Our drag-and-drop Form Builder makes it easy to customize your Emergency Contact Form without any coding. You can add form fields to collect more information, files, and e-signatures, change the template design, and integrate with 100+ apps to automatically sync submissions to your other online accounts. And with our free Jotform Mobile Forms app, you can view submissions on any device, even without internet access — perfect for emergencies. Be prepared for workplace or medical emergencies by knowing who to call with our Emergency Contact Form.