🆘Emergency Information Card

Full name: [Your legal name]. Date of birth: [DOB]. Home address: [Full address]. Phone: [Your cell phone number]. Blood type: [If known, e.g., 'O+' or 'Unknown — please test']. Primary language: [Language]. Religious/cultural considerations: [Any that affect medical care, e.g., 'No blood transfusions' or 'None']. ID location: [e.g., 'Wallet, left pocket' or 'Purse, front zippered compartment']. Medical alert bracelet: [Yes/No. If yes, what condition it lists].

Contact 1 (Primary): Name: [Name]. Relationship: [e.g., 'Spouse']. Phone: [Number]. Alt phone: [Work or home number]. Contact 2: Name: [Name]. Relationship: [e.g., 'Adult child']. Phone: [Number]. Contact 3: Name: [Name]. Relationship: [e.g., 'Sibling']. Phone: [Number]. Out-of-area contact: [Name, phone] — [e.g., 'In case local contacts can't be reached during a widespread emergency']. Special instructions: [e.g., 'Call [Contact 1] first — they have my medical power of attorney. If you can't reach them, call [Contact 2].'].

Allergies: - [Allergy and reaction, e.g., 'Penicillin — causes severe rash and swelling'] - [Allergy, e.g., 'Latex — moderate sensitivity'] - [Food allergy, if severe, e.g., 'Peanuts — anaphylaxis risk. EpiPen in purse.'] Current medications: - [Medication, dose, frequency, e.g., 'Metformin 500mg, twice daily for Type 2 diabetes'] - [Medication, dose, frequency] - [Medication, dose, frequency] Medical conditions: - [Condition, e.g., 'Type 2 diabetes, diagnosed [year]'] - [Condition, e.g., 'High blood pressure, managed with medication'] - [Condition, e.g., 'Previous heart surgery, [year]'] Doctor: [Name, practice, phone]. Pharmacy: [Name, location, phone].

Health Insurance: Provider: [Company name]. Plan: [Plan type, e.g., 'PPO']. Policy/Member ID: [Number]. Group number: [Number]. Phone: [Customer service number on card]. Card location: [e.g., 'Wallet' or 'Photo on phone in "Insurance" album']. Prescription Coverage: Provider: [If different from health]. Member ID: [Number]. Dental Insurance: [Provider, member ID]. Vision Insurance: [Provider, member ID]. Supplemental/Secondary: [If applicable, provider and member ID]. Medicare/Medicaid: [If applicable, number]. Auto Insurance: [Company, policy number] — relevant if in a vehicle accident.

Medical devices: - [e.g., 'Pacemaker — implanted [year], [manufacturer]. MRI precautions apply.'] - [e.g., 'Insulin pump — [brand/model]. Do not remove.'] - [e.g., 'Hearing aids — bilateral. Remove before MRI.'] Do not resuscitate (DNR): [Yes/No. If yes: 'DNR paperwork is on file with [doctor/hospital]. A copy is in [location].'] Organ donor: [Yes/No. Registered: Yes/No]. Advance directive: [Location, e.g., 'On file with Dr. [name] and a copy in the home safe.']. Healthcare proxy: [Name, phone]. Pets at home: [e.g., 'Dog named [name]. If I'm hospitalized, call [neighbor name, phone] to care for them.'] Other: [Any other critical information, e.g., 'I use a wheelchair / I am deaf in one ear / I have a service dog named [name].'].