Ensure your emergency contact(s) name(s) and phone number(s) are current.

Error messages that may may result from submitting the form become visible only after the form is submitted with errors.


The lines below replace or follow the Submit and Cancel buttons when processing is successful.

Your new emergency contact information is stored.

You can continue by selecting from the menu or logout.

This form should initially show the emergency contact information currently stored in the database. The mockup cannot access the database so the form opens with sample data.