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Printable Emergency Contact Form With Both Parents' Information

Keep Your Emergency Information Up-to-Date


Use an emergency contact form like this one and keep it up-to-date.

Keep your emergency contact form up-to-date so you can be reached any time, 24/7.

© Jennifer Wolf, licensed to About.com

Would your kids' school or caregivers know how to reach you in an emergency? What about your ex? Use this printable emergency contact form to ensure that anyone caring for your kids -- from school personnel to neighbors, family members, and friends -- can reach both of you at a moment's notice. Post a copy in a prominent location at home, too, such as your refrigerator!

This Printable Contact Form Includes:

  • Full contact information for both parents

  • Your child's physician and dentist

  • Up to three additional contacts

  • Space for recording your family's visitation and work schedules

Note: The form is in PDF format. You can download Adobe Acrobat Reader if your computer is not configured to read PDF documents.


  1. Print your copy of this form.
  2. Fill out your information. Be sure to include your cell phone and work numbers.
  3. Add your ex's information.
  4. Add contact information for other adults in your child's life, such as local grandparents, aunts, uncles, and close neighbors who could care for your child in an emergency.
  5. Make as many copies as you need.
  6. Save an extra to post on your refrigerator so that it is accessible to babysitters and your kids.
  7. Distribute copies to every person who cares for your kids.
  8. Update the form and distribute new copies every time your contact information (or your ex's) changes due to a new cell phone number, new job, or move.

Frequently Asked Questions:

Do I really need to use a form like this?
Yes. Being prepared for an emergency means being prepared for the unexpected. Even if you are typically with your kids 24/7, you should distribute up-to-date copies of this emergency contact form to anyone who would potentially care for your kids if you were ill or out of town. 

Who should have a copy of the form?
Anyone and everyone who cares for your kids in your absence. This may include babysitters, neighbors, school/daycare personnel, family members, and all of your back-up childcare providers.

Do I need to have the form notarized?
No. Your form does not need to be notarized because you're not using it to communicate your consent for medical treatment, as you would with a medical release form.

Do my ex and I have to agree about what's listed on this form?
No. The form lists each of your phone numbers, information about parenting time schedules, and the phone numbers for your kids' pediatrician, dentist, and school/child care.

How many phone numbers do I need to include?
You should include all of the numbers where both parents can be reached. Generally, this would include your home, work, and cell phone numbers. There is also room on the form for including additional phone numbers, such as the friends and neighbors you rely on in an emergency.

How often should I update my emergency contact form?
Review your emergency contact form least once a year and update it any time the information changes. For example, if your ex gets a new job, print new copies of the form so that you can update his contact information accordingly.

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