Free Employee Information and Emergency Contact Form
This form collects an employee's contact details and emergency contacts after they are hired. It deliberately leaves out Social Security numbers, health questions and anything about protected traits, which keeps your records lean and lower-risk.
Download free (Word .docx)Free · No sign-up · Opens in Microsoft Word and Google Docs · Last reviewed October 2026
Important: please read
This template is a free starting point, not legal advice. MadyHR.ai is not a law firm and cannot give legal advice. Employment law is different in every state, and some cities have their own rules. Laws also change. Before you use this template, check it against the laws where your employees work, and speak to an employment attorney or your state labor department if you are unsure. You use this template at your own risk, and MadyHR.ai accepts no responsibility for how it is used. Links to official government websites are given for information only; MadyHR.ai is not affiliated with or endorsed by any government agency.
When to use this template
On an employee's first day
Annual update of contact details
When an employee moves or changes emergency contacts
Tips before you use it
Collect payroll tax details on the official IRS and state forms, not on this form.
Do not ask about health, family medical history, religion, marital plans or other protected traits.
Keep completed forms confidential and limit access to people who need them.
Template preview
Replace everything in [brackets] and delete the notes for employers before you use it. The Word download contains the full template.
[Company Name]
Employee Information and Emergency Contact Form
Please complete this form and return it to [HR Contact Name]. This information is kept confidential and used only for employment purposes.
Employee details
Full name
Preferred name
Job title
Department
Start date
Home address
Mobile phone
Personal email
Preferred contact method
Emergency contact 1
Name
Relationship to you
Mobile phone
Other phone
Email
Emergency contact 2
Name
Relationship to you
Mobile phone
Other phone
Email
Note for employer (delete before use): Do not add questions about health, disabilities, medications, family medical history, religion, age or immigration status. Payroll tax details belong on Form W-4 and your state withholding form.
I confirm this information is accurate. I will tell [Company Name] if any of it changes.
Should an employee information form ask for a Social Security number?
It does not need to. The Social Security number you need for payroll is collected on Form W-4 (on Form I-9 it is optional unless you use E-Verify). Keeping it off general forms reduces the number of places sensitive data is stored.
Can I ask employees about family medical history for emergencies?
No. The Genetic Information Nondiscrimination Act generally prohibits employers from requesting family medical history. Ask only for emergency contact details.
Official sources
Each source below is an official U.S. government website. Check them for the latest rules.
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