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Ask for the following information on your emergency contact form: The Employees Information. If your company keeps paper files, make sure to add the employees name, job title, or department. Primary Emergency Contact. Secondary Emergency Contact. Home Information. Voluntary Additional Information.
An emergency contact is the first person medical personnel will get in touch with in an emergency, but your emergency contact may not have the legal authority to act on your behalf unless you explicitly provide that power.
Since Emergency Contact Data only stores information that belongs to an individual, the storage nor the facilitation of data is governed by the HIPAA Privacy Rule, as neither Emergency Contact Data nor the individual is a COVERED ENTITY governed by HIPAA.
When choosing your emergency contact, consider family members or friends who live locally and who you trust to make hard decisions on your behalf. Make sure your emergency contacts know where to access your health history, your healthcare providers contact information, and your wishes for certain treatments.
An employee emergency contact form is a document that references an individuals closest family members or friends in the event of a workplace accident or injury. It is commonly required during the hiring process and should be updated every 6-12 months.
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The form should contain basic information such as the employees name, address, and date of birth. Contact details are often included in case you need to get in touch with an employee in an emergency or other important situation.
Emergency contact information means the name, telephone number, or address of an individual that is used for the sole purpose of contacting that individual when the holder of an official state personal identification card has been involved in an emergency.
Aspects of your health history that could be helpful to emergency medical responders, including allergies and immunization record. Phone numbers for professional emergency contacts, such as your family doctor, local emergency services, emergency road service providers, and the regional poison control center.

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