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  1-800-848-2336 ⁠— New Jersey Home Health Care Agency

Senior Care Safety & Emergency Checklist

NJ Senior Safety

Are you prepared to deal with any emergencies that may arise with your elderly loved one?

Below is a list that you, as a caregiver, should keep in an easy-to-reach place should an emergency occur.  The list should be filled out and kept on a refrigerator and/or nightstand.  In times of panic and confusion, you or your senior may forget the most basic information.  Timing is critical and seconds can make a difference.

Fill out this list, review it with your senior citizen and keep multiple copies:

Children’s or Next of Kin’s Full Names, Addresses and phone numbers:

Name__________________  Address ____________________  Phone Number_____________

Name__________________  Address ____________________  Phone Number_____________

Name__________________  Address ____________________  Phone Number_____________

Special Health Concerns:

Medications Taken_____________________________________

Pre-Existing Conditions________________________________

Emergency Contact Information:

Doctor’s Name______________Address_____________Phone Number______________

Nearest Hospital              Address____________ Phone Number______________

Insurance Carrier___________________________Account Number_________________

Police Station Phone Number___________________________

Additional Instructions:



Posted by: Frank Esposito, Vice President of Expert Home Care.  New Jersey’s Expert Home Care provides professional and reliable home health care and companion care for NJ seniors, helping them with their daily living activities since 1984. Please call us toll free at 800-848-2336 when you have elder care related questions or need assistance for a loved one.

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