Emergency Contact Form



Ensuring proper patient-centered care isn’t just limited to diagnosis and treatment, but also extends to offering care when the patient is in a difficult situation. 

If the patient is in a critical condition and is not accompanied by anyone, you should be the one to communicate the information to their family members or emergency contacts. These emergency contacts will not only help you with the required details about the patient but will also be able to make decisions on their behalf. 

In addition to having a complete account of the patient’s past and current health status, insurance information, and consent; you must also keep a record of their emergency contacts. 

This is because if there is a medical emergency and the patient has no one with them at that particular moment, you know whom to call. This is where an Emergency Contact Form comes in handy. 

What Is An Emergency Contact Form? 

An Emergency Contact Form is an essential document that is used to collect the information of a patient’s emergency contacts. This form allows healthcare providers to access those contacts in case there’s a medical emergency or during end-of-life care. 

The document typically contains the patient’s information, the information of the emergency contacts including their phone numbers, email ID, and relationship with the patient, the details of the preferred facility, information related to insurance, and details of the physician. 

Who Fills An Emergency Contact Form? 

An Emergency Contact Form is filled out by the patient. If the patient is a minor, then the form has to be filled out by their legal guardian. 

The form can also be filled out by the patient’s authorized representative or proxy.

This form ensures that all information about the patient’s emergency contacts is readily available in case of a medical emergency. 

Why Should You Digitize An Emergency Contact Form?

If you’re still giving out paper Emergency Contact Forms to your patients, you need to stop, as it is a complete waste of time and energy. In this digital and technically advanced era, you need to digitize your Emergency Contact Form. Here’s why: 

  1. Whenever there is an emergency, you can immediately access the digital emergency contact form, as compared to its paper counterpart. 
  2. You can integrate the digital form easily with your medical software, which ensures that the form is ready accessible whenever required. 
  3. Since the form is digital, you can access the form even remotely if you’re outside the healthcare facility. 
  4. You can ensure HIPAA compliance with your form because it is digitized and securely stored in your EHR
  5. As a front desk manager, you save 3-4 hours of daily time as you no longer need to go through the extensive process of downloading, scanning, printing, and uploading forms. The digital emergency contact form saves you from that hassle. 
  6. Your patient wouldn’t have to visit the facility to fill the form; they can easily fill it on any device at their own convenience. 

All in all, digitizing the emergency contact form will help streamline workflows, save time, and improve overall patient experience. 

How To Digitize The Emergency Contact Form? Best Practices To Follow 

Digitizing the form is quite easy and doesn’t require too much time or effort. However, here are some best practices that you can follow to ensure seamless form sharing and collection. 

  1. Send the digital emergency contact form to the patient via a text message as a link. Make sure that the text message that you send is secure and HIPAA-compliant.
  2. Give a deadline to the patient to complete the form and make sure to remind them constantly to fill out the form before the deadline. 
  3. Use a HIPAA-compliant form builder to add data validations checks such as required fields; doing so will ensure that no important information is missed out. 
  4. Make the form compatible with all types of operating systems and devices. 
  5. Train your staff to ensure seamless updation of emergency contact information. 

How Can You Digitize The Emergency Contact Form With Emitrr? 

If you are looking forward to digitizing your emergency contact form, here’s how you can do so with Emitrr: 

  1. You can download and customize the form available here. Alternatively, if you already have an existing form that you wish to diitize, you can send it to us and we’ll digitize it for free
  2. You can use Emitrr’s texting functionality to send secure text messages containing the form link to the patient. This will ensure HIPAA-compliance
  3. Emitrr’s texting services will help you send automated reminders and follow up messages to your patients to ensure that they’re submitting the form timely. 
  4. Emitrr integrates with a host of EHRs that will further help you streamline operations. Here’s a complete list of Emitrr’s integrations – https://emitrr.com/integrations/ 
  5. Emitrr’s forms are device compatible, which will further help ensure better patient experience

In order to improve the overall efficiency of your practice, then going digital is one of the most important steps that you need to take. If you want to get your medical forms digitized for free, reach out to us now!