EMERGENCY CONTACT LIST TEMPLATE
(For Immediate Use)
Personal Information
- Name: __________________________________
- Date of Birth: ___________________________
- Address: ________________________________
- Phone Number: __________________________
- Email Address: __________________________
PRIMARY EMERGENCY CONTACT
- Name: __________________________________
- Relationship: ____________________________
- Phone Number: __________________________
- Alternate Phone Number: __________________
- Email Address: __________________________
SECONDARY EMERGENCY CONTACT
- Name: __________________________________
- Relationship: ____________________________
- Phone Number: __________________________
- Alternate Phone Number: __________________
- Email Address: __________________________
DOCTOR’S CONTACT INFORMATION
- Doctor’s Name: ___________________________
- Phone Number: ___________________________
- Medical Facility/Practice: ________________
- Special Instructions/Conditions: ____________
INSURANCE INFORMATION
- Insurance Company Name: _________________
- Policy Number: ___________________________
- Emergency Services Phone Number: _________
ADDITIONAL EMERGENCY CONTACTS
- Name: __________________________________
- Relationship: ____________________________
- Phone Number: __________________________
- Alternate Phone Number: __________________
- Email Address: __________________________
Why Choose Professional Care at VataVriksh Parent Care
for Parents Instead of Home Care
Choosing professional care ensures that parents are engaged, safe, and well-cared for, providing them with a higher quality of life compared to home care. Here are the reasons:
Social Interaction
Freedom and Space
Variety and Stimulation
Safety and Security
Activities and Engagement
Personalized Care
Handling Special Conditions
Continuous Care
Addressing Needs
Handling Irritation and Anger
Avoiding Monotony
Improving Communication Skills
Variety in Interaction
Caregiver Well-being
