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

MyKinFolderMyKinFolder

Call in this order

  1. 1. Dana Thompson (Daughter · primary) — (614) 555-0188
  2. 2. Michael Thompson (Son) — (614) 555-0119
  3. 3. Ruth Alvarez (Neighbor / key holder) — (614) 555-0233

Medical contacts

Dr. Anita PatelPrimary care · (614) 555-0400 · Riverside Family Medicine

Dr. Marcus ReyesCardiology · (614) 555-0611 · Heart Center, Suite 240

Larkspur PharmacyPreferred pharmacy · (614) 555-0777 · 45 Main St

Home and pets

Home accessSpare key with Ruth next door · alarm code on file

PetsBiscuit (cat) — fed twice daily, vet: Worthington Animal Clinic

TransportNo longer drives after dark; Dana drives to appointments

Insurance

MedicarePart A & B · Member 1EG4-TE5-MK72

AARP SupplementPlan G · Member 9928-4471

Sample data — nothing here is real. Your workspace prints this page with your parent's information.

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.

RowWhat to fill inNote to add
Call firstName, relationship, mobileMakes medical decisions; reachable day or night
Backup 1Name, relationship, mobileSecond call if the first does not answer
Backup 2Name, relationship, mobileOut-of-state sibling to keep informed
Local helpNeighbor or building manager, mobileHas a key; can be there quickly
CaregiverName or agency, phone, days coveredKnows the daily routine and medications
Primary physicianPractice name, phone, portalRecords and refills
SpecialistsName, specialty, phoneCardiology, oncology, neurology, and so on
PharmacyName, phone, addressWhere prescriptions are filled
LegalPower of attorney or proxy, phoneWhere 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.

Caregiver-informed

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.

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