Bruceville-Eddy, TX · McLennan County
Emergency Contact Information Form
This form collects a person's contact, emergency contact, preferred hospital, and other information for an officer or emergency care provider.
What this form is
The Emergency Contact Information Form records the person's name, phone numbers, driver's license or ID number, date of birth, and address. It asks for primary and secondary emergency contacts, their relationships and phone numbers, a preferred local hospital, and comments about special medical or personal information. The signer is asked to sign and date the form.
Who needs it
People providing emergency contact information for an officer or emergency care provider can complete this form with their personal and contact details.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed without a notary; the signer just signs and dates it on the form.
How to submit this form
- 1
Download The Form
Download the Emergency Contact Information Form.
- 2
Complete The Form
Fill in your personal details, emergency contacts, preferred local hospital, and any comments you want an officer or emergency care provider to know.
- 3
Review And Sign
Review the information, then sign and date the form.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What information does the Emergency Contact Information Form request?
- It requests personal contact and identification details, primary and secondary emergency contacts, a preferred local hospital, and comments about special medical or personal information.
- Do I need a notary for the Emergency Contact Information Form?
- No. This form is signed without a notary; the signer just signs and dates it on the form.
- How do I submit the Emergency Contact Information Form?
- Submit it to the city department named on the form; check the city website for current contact details. The form itself does not name a department or give submission instructions.
Need something notarized?
This Emergency Contact Information Form doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.