Emergency Patient Info Form

In a serious emergency, every second counts. When EMTs come to your aid, they will ask you to quickly produce a variety of information to help guide the emergency care of your loved one. This form will help you compile medications, medical history, insurance information, and other vital information to save precious time.

3 Steps to Protect Your Family:

  1. Download and Print the form

  2. Complete the form

  3. Hang the form on your refrigerator


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