Works for Me Wednesday: Emergency Forms for Caregivers

Tuesday, July 8, 2008

My son had nannies until he was 4. For our family, it was what worked the best. I wanted all the information necessary in case of any type of emergency to be readily available.

I created this Emergency Contact Info packet for our caregiver's to use. I created the forms in Microsoft Word. I taped the Emergency Contact form inside the pantry.

(Click on thumbnails to view larger PDF)

I also had, in an envelope taped to the pantry, the following other forms:

1. A second copy of the Emergency Contact form
2. A copy of his birth certificate
3. The fingerprints we had done as part of a Child ID kit
4. A Consent for Treatment form I found online and modified
5. A copy of his immunization record
6. Fingernail clippings (totally morbid, I know, but I’m prone to paranoia)
7. A copy of his medical card

I showed our nanny all the forms and had her sign the consent for treatment. Fortunately, we never needed to use any of this information. I don't believe we can be too careful when it comes to our children. It may seem like overkill, but I took comfort in being prepared for anything, and it made leaving my child with someone else a little easier.

*For other helpful tips, head over to Shannon's.
add to kirtsy


  1. My teen carries some with her just in case the parents aren't savvy about having forms ready. They fill 'em out the first time she works for them and appreciate her professionalism!

  2. This is a great idea. I also make sure that when my 10 year old goes to a friend's house, she has a card with all of our phone numbers and the numbers of relatives who live in the area in case something happens.

    Great advice...thanks!

  3. That's really smart.
    (Were the fingernail clippings for DNA?)

    Just wondering. I'm prone to paranoia too and wonder if I missed out on doing something to mitigate my paranoia.

  4. We would like to introduce the MyLifeFile™ Emergency Information Kit. This kit is specifically designed to organize important personal information and keep it in a handy, easy to access place, so that if you have to leave your home in a hurry, you have every thing you need at your fingertips.

    Passports, birth certificates, insurance information, emergency money, financial information and more are stored in the MyLifeFile™ so if you are ever forced to leave your home for any reason, you can be confident that your personal information is safe with you.

    Please take a moment to look at the information provided or on our website at

  5. I also heard that now-a-days you have to have some sort of HIPPA language in the consent to treat forms because the HIPPA laws keep doctors from being able to release certain information.

  6. I need to do this. Thanks for sharing!

  7. After the way you rescued Chase when he had a bee stuck in his glasses, while I ... picked my nose (?), I'm not surprised at your preparedness.


Thank you for visiting and letting me know your thoughts!

copyright melanie sheridan 2009 template design by Studio Mommy (© copyright 2015)