Pest Management & Crop Protection
Emergency Contact Sheet for Pesticide Incidents
Use this emergency contact sheet for pesticide incidents to list the numbers your crew needs fast, including poison control, hospital and farm contacts, in one posted place.
Download free PDF1 page, US Letter, prints clean in black and white
FormPest Management & Crop ProtectionFree PDF
What you fill in
- Farm name and address
- Poison control number
- Nearest hospital and directions
- Local emergency services
- Farm owner and manager contacts
- State agriculture agency contact
- Product and label location
- Date sheet updated
How to use this form
Fill it out at the time of the event, check it over, and store it where you can find it. Copy it for anyone who needs a record.
Where to check the details
This sheet is a general template, so confirm specifics with your own manuals, labels and local rules. For current official guidance, start with CDC and OSHA.
For more in this area, see the row crop calendar. Between chores, farm.FM has farm humor, including The Unofficial State Bird: The Flying Pesticide Drone, and farming farm stories.