Employee form
Rafael Ortiz
CompleteEmergency contacts
Emergency contacts
- Contact name
- Luis Ortiz
- Relationship
- Spouse
- Phone
- (720) 555-0131
- Second contact
- Frank Lopez
- Second contact's phone
- (303) 555-0199
- Anything a first responder should know
- Allergic to bee stings; carries an EpiPen in his truck.
- Your preferred phone
- —
- Primary contact's alternate phone
- —
- Second contact's relationship
- Sister
- Communication or accessibility needs
- —
Submission history
- Sept. 21, 2026, 11:55 a.m. · dana.whitfield@frontrange-roofing.example Sept. 21, 2026, 11:55 a.m. · dana.whitfield@frontrange-roofing.example · Approved Download submitted copy