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2023-2024 Emergency Contact Form (blue card)

You can fill this form out in your NYC schools account, where you can also see your student grades, test scores, take classes in Parent University, Report bullying, Access forms for your child, Reset your child's DOE account password, Access SupportHub and more!

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Student Information

Primary Guardian Information

This Guardian Can:*
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Ok to text*
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Additional Guardian Information

This guardian can*
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Ok to text?*
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Emergency Contact Information

List below names of three additional people who may be called in case of emergency or if child is sick in school.

No access: If there is a person who may NOT HAVE ACCESS to child please indicate:

Order of Protection
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Health information

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Does child have any health condition that may affect participation in physical activities?
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Known Diagnoses (check all that apply)
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My child has
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It is understood that in the final disposition of an emergency case, the judgment of the school authorities will prevail.
The recommendation of the parent as indicated above will be respected as far as possible.

Signature of parent/guardian
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