LIFE’S CHECKLISTS · FREE WORKSHEET
Household emergency contacts
Keep a printed copy where your household can find it. Avoid public sharing.
First read the completed example. Then write your own answers in the blank sections. If you do not know an answer, write what you need to ask. Official applications may require their own forms.
Completed example
This is a fictional practice entry. Write your own details in the blank sections below.
- Need / person
- Out-of-area contact
- Phone / official route
- Fictional contact: Aunt Lee; actual number kept privately
- When to use
- Household check-in after a disruption
- Notes
- Permission confirmed; paper copy in emergency folder
Date: ____________________
Emergency services
Phone / official route
When to use
Notes
Out-of-area contact
Phone / official route
When to use
Notes
Landlord / property maintenance
Phone / official route
When to use
Notes
Gas utility emergency
Phone / official route
When to use
Notes
Electric utility
Phone / official route
When to use
Notes
Poison Control (U.S.)
Phone / official route
When to use
Notes
Insurance claim line
Phone / official route
When to use
Notes
Meeting place
Phone / official route
When to use
Notes
Notes: