EMERGENCY CONTACT INFORMATION VERIFICATION

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--- FARM OWNER/OPERATOR INFORMATION ---
[ ] Owner/Operator Full Name
[ ] Primary Phone Number
[ ] Secondary Phone Number (optional)
[ ] Email Address
[ ] Brief Description of Farm Operations (for emergency context)
[ ] Farm Address (for location services)
[ ] Date of Last Contact Verification
[ ] Relationship to Farm (e.g., Owner, Manager)

--- KEY FARM PERSONNEL ---
[ ] Employee Full Name
[ ] Employee ID (if applicable)
[ ] Primary Phone Number
[ ] Secondary Phone Number (optional)
[ ] Email Address (optional)
[ ] Brief Description of Responsibilities (e.g., equipment operator, livestock handler)
[ ] Emergency Contact Relationship to Employee (e.g., Spouse, Parent, Friend) (Spouse, Parent, Friend, Other)
[ ] Emergency Contact Name
[ ] Emergency Contact Phone Number

--- LIVESTOCK/CROP SPECIFIC CONTACTS ---
[ ] Primary Crop Type(s) (Corn, Soybeans, Wheat, Hay/Alfalfa, Fruits (Specify in LONG_TEXT), Vegetables (Specify in LONG_TEXT), Other (Specify in LONG_TEXT))
[ ] Specific Crop Varieties & Location(s)
[ ] Livestock Type (if applicable) (Cattle, Poultry, Pigs, Sheep/Goats, Dairy, Horses, Other (Specify in LONG_TEXT))
[ ] Livestock Specific Needs/Concerns
[ ] Approximate Livestock Count
[ ] Crop/Livestock Manager Name
[ ] Crop/Livestock Manager Phone Number
[ ] Crop/Livestock Manager Alternate Phone Number
[ ] Special Instructions/Notes

--- EQUIPMENT & MACHINERY CONTACTS ---
[ ] Contact Name (Equipment Specialist)
[ ] Phone Number (Mobile)
[ ] Phone Number (Home/Office)
[ ] Email Address
[ ] Equipment Expertise (Specific Machinery)
[ ] Years of Experience with Farm Equipment
[ ] Primary Equipment Type Managed (Tractors, Combines, Sprayers, Harvesters, Irrigation Systems, Livestock Handling Equipment, Other)
[ ] Primary Location of Equipment Expertise
[ ] Equipment Manuals/ Schematics (Optional)

--- CONTRACTOR/SERVICE PROVIDER CONTACTS ---
[ ] Contractor/Service Provider Name
[ ] Company Name (if applicable)
[ ] Primary Phone Number
[ ] Secondary Phone Number (Optional)
[ ] Email Address
[ ] Service Provided (e.g., Pesticide Application, Irrigation Repair)
[ ] Emergency Contact Preference (Phone/Email) (Phone, Email)
[ ] Brief Description of Emergency Response Responsibilities

--- LOCAL EMERGENCY SERVICES & KEY CONTACTS ---
[ ] Local Fire Department Phone Number
[ ] Local Police Department Phone Number
[ ] County Sheriff's Department Phone Number
[ ] Emergency Medical Services (EMS) Phone Number
[ ] Local Hospital Phone Number
[ ] State Department of Agriculture Contact Number
[ ] Local Veterinary Services Phone Number (if applicable)
[ ] Location of Nearest Fire Hydrant (if applicable)
[ ] Primary Point of Contact for Agricultural Emergencies (e.g., spill response) (County Extension Agent, State Department of Agriculture Representative, Local Crop Consultant)

--- END OF TEMPLATE ---
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