|
The content on or accessible through Medpedia.com is for informational purposes only. Medpedia is not a substitute for professional advice or expert medical services from a qualified health professional.
Read more
|
Emergency Reference Card
There are currently no Lead Editors of this article.
Ask a Question on This Topic
Important Resources for Emergency Reference Card:
There is 1 user following this page.
The information on this page is seed content provided by an organization. Please help improve this Article by adding to it. If you are a physician or PhD, learn how to edit. If you are anyone else, learn how to suggest changes.
Emergency Reference Card for Individuals with Medical Needs Living at Home & Their Caregivers
| Name: | DOB: | Blood Type: | ||||
|---|---|---|---|---|---|---|
| Street Address: | City: | State: | Zip Code: | |||
| Personal medical information that emergency responders need to know: | ||||||
| Allergies I have: | ||||||
| Medications I take: | ||||||
| Prescription Name: | Dosage (for example, 50 mg) | Frequency (for example, twice per day) | ||||
| . | . | . | ||||
| . | . | . | ||||
| . | . | . | ||||
| . | . | . | ||||
| Vaccination Type: | Dose/Units: | Date Given (month/year) | ||||
| . | . | . | ||||
| . | . | . | ||||
| . | . | . | ||||
| Special needs (e.g., eye glasses, hearing aids, mobility assistive devices, language translation needs, etc.): | ||||||
| Emergency Phone Numbers (if not 911) | ||||||
| Local Dept: | Phone # | Emergency Contacts / Name | Phone # | |||
| Ambulance | . | Doctor | . | . | ||
| Fire | . | Doctor | . | . | ||
| Police | . | Doctor | . | . | ||
| County Health | . | Clinic/Facilty | . | . | ||
| Emergency Mgmt | . | Pharmacist | . | . | ||
| Local Red Cross | . | Dentist | . | . | ||
| Local Shelters | . | Veterinarian | . | . | ||
| Family and Friends - Emergency Contacts | ||||||
| . | Name | Phone | . | Name | Phone | |
| Family Member | . | Home:
Work: Cell: | Friend/Neighbor | . | Home:
Work: Cell: | |
| Family Member | . | Home:
Work: Cell: | Friend/Neighbor | . | Home:
Work: Cell: | |
| Family Member | . | Home:
Work: Cell: | Friend/Neighbor | . | Home:
Work: Cell: | |
| Family Member | . | Home:
Work: Cell: | Friend/Neighbor | . | Home:
Work: Cell: | |
| Family Member | . | Home:
Work: Cell: | Friend/Neighbor | . | Home:
Work: Cell: | |
To suggest changes to this page, you must create an account on Medpedia.
The content on or accessible through Medpedia.com is for informational purposes only. Medpedia is not a substitute for professional advice or expert medical services from a qualified health professional.
Read more