"Emergency Contact Information Form" - Niagara County, New York

Emergency Contact Information Form is a legal document that was released by the Human Resources Department - Niagara County, New York - a government authority operating within New York. The form may be used strictly within Niagara County.

Form Details:

  • Released on August 1, 2019;
  • The latest edition currently provided by the Human Resources Department - Niagara County, New York;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Human Resources Department - Niagara County, New York.

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NIAGARA COUNTY
STATE OF NEW YORK
HUMAN RESOURCES
County of Niagara
DEPARTMENT
EMERGENCY CONTACT INFORMATION FORM
Date: _________________
Employee Name (Print): ________________________________________________________
Primary Contact: ________________________________ Relationship: __________________
Primary Phone Number: __________________________ Type: ________________________
Secondary Phone Number: ________________________ Type: ________________________
Secondary Contact: _____________________________ Relationship: ___________________
Primary Phone Number: __________________________ Type: ________________________
Secondary Phone Number: ________________________ Type: ________________________
Additional Information: _________________________________________________________
REVISED 8/1/2019
NIAGARA COUNTY
STATE OF NEW YORK
HUMAN RESOURCES
County of Niagara
DEPARTMENT
EMERGENCY CONTACT INFORMATION FORM
Date: _________________
Employee Name (Print): ________________________________________________________
Primary Contact: ________________________________ Relationship: __________________
Primary Phone Number: __________________________ Type: ________________________
Secondary Phone Number: ________________________ Type: ________________________
Secondary Contact: _____________________________ Relationship: ___________________
Primary Phone Number: __________________________ Type: ________________________
Secondary Phone Number: ________________________ Type: ________________________
Additional Information: _________________________________________________________
REVISED 8/1/2019