Each staff member should complete the following form. Completed forms are retained in the Administrative Office. Having this information readily available may save time in an emergency situation.
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DREW UNIVERSITY LIBRARY
EMERGENCY CONTACTS FOR LIBRARY PERSONNEL
If you wish, you can ensure your colleagues know whom to call when you have taken ill or had an accident. The information may be on a published list, or you may indicate that the information is on file in the Administrative office. Or you may decide to have the basic information on a public list and indicate that further information is available in the office. Please fill out the form below, indicating your choice for publication and return to the Library Human Resources Administrator.
A check in the box will indicate your permission to publish.
NAME+ +
G CONTACT NAME+ +
CONTACT PHONE NUMBER(S)
G ALTERNATE CONTACT NAME+ +
CONTACT PHONE NUMBER(S)
The following information will NOT be published but will be kept on file in the Administrative Office if you choose to fill it out.
PRIMARY PHYSICIAN:
PHONE NUMBER:
HOSPITAL TO USE (IF POSSIBLE)
BLOOD TYPE+ +
ALLERGIES+ +
OTHER INFORMATION: