Personal Family List

PERSONAL FAMILY LIST

Purpose: This Personal Family List is a confidential compilation of family members, emergency contacts, and locations of important documents for use by the preparer and designated family members. Completion of this form does not create legal authority, transfer rights, or substitute for a will, power of attorney, or other formal legal instruments. Do not include account passwords or other authentication credentials on this form.

Prepared By

Name:    Date completed:

Primary Contact (Owner)

Spouse / Partner

Children (List minors first)

Relationship:    Date of birth:    Minor:

Relationship:    Date of birth:    Minor:

Parents

Relationship:    Phone:

Relationship:    Phone:

Siblings & Other Close Relatives

Relationship:    Phone:

Relationship:    Phone:

Emergency Contacts (Primary and Secondary)

Relationship:    Phone:    Alternate phone:

Relationship:    Phone:

Medical & Care Information

Phone:    Preferred hospital:

Legal Representatives & Important Documents

Funeral, Disposition & Personal Wishes

Guardianship for Minor Children (if applicable)

Additional Notes

Certification

I certify that, to the best of my knowledge, the information provided on this Personal Family List is accurate and complete. I understand that this document is for family reference and emergency use only and does not by itself confer legal authority or replace formally executed legal instruments such as a will, trust, or power of attorney. I authorize the release of the emergency contact and medical information contained in this form to designated family members, medical personnel, and legal representatives as necessary in an emergency.

Confidentiality notice: This form contains personal information. Handle in accordance with accepted privacy practices. Do not include account passwords, PINs, or other access credentials on this form.

Sign Now