Emergency Contact Sheet for Caregivers
In an emergency, every second counts. Having all essential contacts and medical information in one accessible place can make the difference between confusion and confident action. This template ensures you, your family, and any caregivers have exactly what they need when it matters most.
Download and Post
Print this sheet and post it in a visible location in your parent's home—on the refrigerator is traditional. Also keep copies with all family caregivers and in your phone.
Download PDFWho Is This Template For?
This template is designed for:
- Families caring for an aging parent at home
- Long-distance caregivers who need to share critical info with local helpers—see our long-distance caregiving guide
- Home care aides and professional caregivers who need access to emergency info
- Neighbors who check in and may need to respond to emergencies
The Emergency Contact Sheet
Emergency Numbers
Call 911 for Emergencies
Person's Full Name:
________________________
Date of Birth:
________________________
Home Address:
________________________________________________
Primary Emergency Contacts
Contact #1 (Primary)
Name:
________________________
Relationship:
________________________
Phone (Primary):
________________________
Phone (Alternate):
________________________
Contact #2 (Secondary)
Name:
________________________
Relationship:
________________________
Phone (Primary):
________________________
Phone (Alternate):
________________________
Healthcare Providers
Primary Care Doctor
Doctor's Name:
________________________
Practice Name:
________________________
Phone Number:
________________________
After-Hours Number:
________________________
Specialists (Add as needed)
Specialty:
____________
Doctor's Name:
____________
Phone:
____________
Specialty:
____________
Doctor's Name:
____________
Phone:
____________
Pharmacy
Pharmacy Name:
________________________
Phone Number:
________________________
Address:
________________________________________________
Critical Medical Information
Must-Know Medical Info
ALLERGIES (Medications, Foods, Other):
________________________________________________
Major Medical Conditions:
________________________________________________
Blood Type (if known):
________________________
Where is the full medication list?
________________________
Keep a detailed medication list using our medication tracker template and note its location on this sheet.
Insurance Information
Health Insurance
Insurance Company:
________________________
Policy Number:
________________________
Medicare Number:
________________________
Member Services Phone:
________________________
Local Support Contacts
Neighbors and Local Helpers
Neighbor Name:
________________________
Phone:
________________________
Home Care Aide/Agency:
________________________
Phone:
________________________
Where to Post and Share
On the refrigerator
The traditional spot—EMTs know to look here.
By the main phone
Easy access when making calls.
In your phone
Take a photo or save a digital copy.
With all family caregivers
Everyone should have a copy.
With home care aides
Anyone providing care needs this info.
In a go-bag for hospital visits
Ready to grab in an emergency.
Key Takeaways
- Post this sheet in a visible location—refrigerator door is standard
- Include allergies prominently—they're critical in medical emergencies
- List both primary and backup contacts for each category
- Update immediately when any information changes
- Share copies with all family members and caregivers
Keep Your Care Team Connected
CareClearly helps families share important information, coordinate care tasks, and stay connected—so everyone knows what's happening with your loved one's care.
Try CareClearly FreeRelated Resources
This emergency contact sheet works alongside other important caregiving tools:
- Medication Tracker Template — Keep a detailed list of all medications
- Home Safety Checklist — Prevent emergencies before they happen
- Essential Caregiver Documents — Legal documents you need organized
Frequently Asked Questions
How often should I update the emergency contact sheet?
Review and update whenever any information changes—new doctor, phone number change, medication update. Even if nothing changes, review the sheet every 3-6 months to ensure everything is current. Date each version so you know when it was last updated.
Should I include a DNR or other advance directive information?
Yes, if applicable. Note whether a DNR (Do Not Resuscitate) order exists and where the original document is located. EMTs and hospital staff need to know this quickly. If there's no DNR, you can note that too.
What if my parent has dementia and might remove or lose the sheet?
Post it inside a cabinet door or in a less obvious but still accessible location. Give copies to neighbors who check in. Consider a medical alert bracelet for critical information. Let local EMS know about your parent's situation if there are frequent calls.
Should I include financial information on this sheet?
No—keep financial details separate for security. This sheet is for emergency response and medical care. Store financial and legal document information in a secure location and share only with appropriate family members.