Caregiving template
An emergency contact list your family can actually use
A list of ten numbers with no context is not a contact list. Rank who to call first, say what each person can do, and print it for the refrigerator, the go-bag, and every sibling's phone.
Free to start. The printable Emergency Information Sheet is free; the full document set is Premium.
Family Summary
Mary Thompson
DOB Mar 4, 1943 · 83 yrs
Current concerns
Ankle swelling — watching daily, mention at cardiology
Missing two evening doses each week
Who is responsible for what
Dana — Medical appointments and medications
Michael — Finances and insurance
Ruth — Groceries and weekend check-ins
Open decisions
Should we add in-home help two mornings a week?
Who keeps the second set of house keys?
Active tasks
Refill blood pressure Rx — Dana · due Aug 3
Call about the swelling — Michael · no due date
Important contacts
Dr. Alvarez (cardiology) — (555) 330-8812
Third St. Pharmacy — (555) 447-2201
Recent family updates
Aug 1 · Dana — Good day. Ate well, walked to the mailbox.
Jul 29 · Michael — Insurance card copy is in the folder now.
What the Contact Sheet prints
- The one person to call first, labeled clearly
- Backup family contacts with relationship and mobile
- Primary physician and specialists
- Preferred pharmacy with phone and address
- Neighbor or building manager who has a key
- Paid caregiver or home health agency
- Whoever holds power of attorney or is health care proxy
- Utilities, repair, and transport contacts the household relies on
What the finished contact sheet looks like
This is the actual Contact Sheet, filled in with sample data — ranked so a caregiver knows who to call first.
Contact Sheet
Mary Thompson
DOB March 4, 1944 · sample data
Call in this order
- 1. Dana Thompson (Daughter · primary) — (614) 555-0188
- 2. Michael Thompson (Son) — (614) 555-0119
- 3. Ruth Alvarez (Neighbor / key holder) — (614) 555-0233
Medical contacts
Dr. Anita Patel — Primary care · (614) 555-0400 · Riverside Family Medicine
Dr. Marcus Reyes — Cardiology · (614) 555-0611 · Heart Center, Suite 240
Larkspur Pharmacy — Preferred pharmacy · (614) 555-0777 · 45 Main St
Home and pets
Home access — Spare key with Ruth next door · alarm code on file
Pets — Biscuit (cat) — fed twice daily, vet: Worthington Animal Clinic
Transport — No longer drives after dark; Dana drives to appointments
Insurance
Medicare — Part A & B · Member 1EG4-TE5-MK72
AARP Supplement — Plan G · Member 9928-4471
Want this page in your hands right now?
Print the blank version and fill it in by hand — no account, no email. Or create a workspace and it fills itself in, stays current, and reprints whenever something changes.
The blank template is free and always will be. Open the full-size sample.
Rank the list, do not just collect it
In an emergency, whoever is holding the page calls from the top down. Put the family member who can make decisions first, name the relationship, and add a one-line note about what they can do. That single line is the difference between a list and a plan.
Include someone who can be there in fifteen minutes
Most families list only relatives, and most relatives are not local. A neighbor with a key, a building manager, or a caregiver who can meet the ambulance and secure the house is often the most valuable entry on the page.
One list, updated by everyone who helps
Phone numbers change, doctors change, caregivers change. Keeping contacts in a shared workspace instead of one sibling's document means the printed copy on the fridge matches reality — and anyone can reprint it after a change.
Emergency contact list template
Copy this structure if you are writing one by hand, or enter it once in MyKinFolder and print the completed Contact Sheet.
| Row | What to fill in | Note to add |
|---|---|---|
| Call first | Name, relationship, mobile | Makes medical decisions; reachable day or night |
| Backup 1 | Name, relationship, mobile | Second call if the first does not answer |
| Backup 2 | Name, relationship, mobile | Out-of-state sibling to keep informed |
| Local help | Neighbor or building manager, mobile | Has a key; can be there quickly |
| Caregiver | Name or agency, phone, days covered | Knows the daily routine and medications |
| Primary physician | Practice name, phone, portal | Records and refills |
| Specialists | Name, specialty, phone | Cardiology, oncology, neurology, and so on |
| Pharmacy | Name, phone, address | Where prescriptions are filled |
| Legal | Power of attorney or proxy, phone | Where the signed document is kept |
Print one for the refrigerator, one for the go-bag, and save a PDF on each family member's phone.
There are people out there who are not in a state of mind to be organized — they need this.
— A former nurse and family caregiver
MyKinFolder was built by a family navigating care for a parent, with guidance from people who have worked on both sides of the hospital desk.
Common questions
- Who should be on an emergency contact list?
- One call-first family member, one or two backups, the primary physician, the preferred pharmacy, a local neighbor or building manager who has a key, any paid caregiver, and whoever holds power of attorney. Six to nine entries is usually right — a longer list slows people down.
- How many emergency contacts should we list?
- Two or three family members, clearly ranked. Hospital staff work top-down and stop at the first person who answers, so ordering matters more than length.
- What should each entry include?
- Name, relationship to your parent, mobile number, and a short note on what that person can do — has a key, handles medical decisions, lives ten minutes away. The note is what makes the list usable by a stranger.
- Should we include a local contact even if family lives far away?
- Especially then. Someone fifteen minutes away who can check the house, let the dog out, or meet the ambulance is often more useful in the first hour than a daughter three states away.
- Where do we post it?
- On the refrigerator, inside the front door or by the phone, in the go-bag, and as a PDF on each family member's phone. Caregivers and house sitters should be shown where it is on their first visit.
- How do we keep it current?
- Keep the contacts in one shared place instead of a document one person owns. Everyone you invite to a MyKinFolder workspace can update a number and reprint the Contact Sheet in a minute.
Fill it in once. Reprint whenever it changes.
MyKinFolder keeps each parent's care information in a private workspace your family shares, so every printout is current. Profile capacity depends on your plan: Free supports one parent, while Premium supports two separate parent profiles.
Create my workspaceRelated caregiving guides
- How to care for elderly parents without losing your footing
- What to do when a parent refuses the care they need
- How to share caregiving with siblings without a fight
- Questions to ask at your parent's doctor appointment
- The emergency readiness checklist for an aging parent
- How to coordinate a parent's care without a 47-message group text