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EMPLOYEE EMERGENCY CONTACT FORM Name Department Personal Contact Info: Home Address City, State, ZIP Home Telephone # Cell # Emergency Contact
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Phone # Medical Records Name Age Occupation Gender Race Address City, State, ZIP Contact Information for Personnel to Contact If you have a complaint related to this policy you may contact: Department of Defense Personnel Safety and Security Bureau of Security, Health, and Logistics ATTN: N/A 7201 E. Jackson Blvd. Indianapolis, IN 46206 (Fax) Please remember that all comments must relate to the safety and security of our employees. Comments relating to discrimination, discrimination threats, sexual harassment, retaliation, etc., are not allowed. Only questions pertaining to workplace safety or security, etc.
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