The Student Emergency Contact Form Template by WPForms is a crucial tool for educational institutes that are looking for an efficient way to gather important emergency information regarding their students.
How Does the Student Emergency Contact Form Template Work?
The Student Emergency Contact Form Template requires the WPForms Pro License and the Signature Addon to collect all important information about a student in the event of an emergency and receive parental consent to perform any medical intervention if necessary. Fields include:
- Student Information:
- Full Name: Captures the student’s name for identification in emergencies.
- Date of Birth: For verifying the student’s age for medical considerations.
- Gender: Provides necessary demographic information for safety records.
- Grade Level: Helps in categorizing students by educational stage.
- Student ID Number: For quick reference in the school’s system.
- Home Address: Critical for reaching the student’s residence if needed.
- Primary Emergency Contact:
- Name: The first point of contact in case of an emergency.
- Relationship to Student: Clarifies the connection to the student
- Home Phone, Work Phone, Cell Phone: Multiple contact numbers ensure accessibility in various situations.
- Email Address: For communication in non-urgent scenarios.
- Secondary Emergency Contact:
- Name: An additional contact person for emergencies.
- Home Phone, Work Phone, Cell Phone, Email Address: Similar to primary contact, providing alternative communication methods.
- Additional Contact(s):
- Name: Extra contacts for broader safety coverage.
- Relationship to Student, Phone Number, Email Address: Additional backup for emergency situations, ensuring there’s always someone reachable.
- Medical Information:
- Known Allergies: For immediate medical care in case of an allergic reaction.
- Medications: Information on any medications the student is taking.
- Primary Care Physician: A crucial contact for medical emergencies.
- Physician Phone Number: Direct line to the student’s healthcare provider.
- Consent and Acknowledgement:
- Permission for Emergency Medical Care: Authorization allowing school authorities to seek medical care for the student if necessary.
- Signature and Date: Confirmation from the parent for the accuracy of the information and consent for emergency actions.
Sign up with WPForms today and access the Student Emergency Contact Form Template. Safeguard your students and improve your emergency response procedures.
