Associate Emergency Questionnaire
Current Emergency Information
During an emergency, we will make every attempt to account for each of our associates. In an effort to ensure we can do this efficiently, please provide the information requested below.
Emergency:
Not Selected
Associate Name:
9-digit Associate ID:
Today's Date:
Current Location:
Current Phone Number:
Are you able to work
Not Selected
Yes
No
Can you or have you reached your supervisor?
Not Selected
Yes
No
What is your situation: