Tips for Creating an Emergency Health Information Card



This fact sheet is designed to provide a check list for activities for Creating an Emergency Health Information Card to improve your emergency preparedness in an earthquake. It is designed to be used in conjunction with Independent Living Resource Center San Francisco's general EARTHQUAKE TIPS FOR PEOPLE WITH DISABILITIES, EARTHQUAKE TIPS FOR PEOPLE WITH A SPECIFIC DISABILITY (i.e., Mobility, Visual, Communication, Cognitive, Psychiatric, Hearing, etc), and TIPS FOR COLLECTING EMERGENCY DOCUMENTS. Without all four tip sheets you do not have all the information you need to be prepared Preparation may seem like a lot of work. It is. Preparing does take time and effort. So do a little at a time, as your energy and budget permit. The important thing is to start preparing. The more you do, the more confident you will be that you can protect yourself, your family, and your belongings.

 

DATE COMPLETED / ACTIVITIES

__________ Complete and/or Customize Health Card

__________ Keep copies in wallet, purse and all emergency supply kits

Customize Card

An emergency health information card communicates to rescuers what they need to know about you if they find you unconscious or incoherent, or, if they need to quickly help evacuate you. An emergency health information card should contain information about medications, equipment you use, allergies and sensitivities, communication difficulties you may have, preferred treatment and treatment-medical providers, and important contact people.

Copies of Card

Make multiple copies of this card to keep in emergency supply kits, emergency carry-with-you kits, car, work, wallet and purse (behind drivers license or primary identification card) wheelchair pack, etc.

Put these items on the front:

  1. Name
  2. Street Address
  3. City, State, Zip
  4. Phone (Home, Work)
  5. Fax No
  6. Birth date
  7. Blood Type
  8. Social Security No.
  9. Health Insurance Carrier and Individual and Group #
  10. Physicians
  11. Put these items on the back:

  12. Emergency Contacts
  13. Conditions, Disability
  14. Medications
  15. Assistance Needed
  16. Allergies
  17. Immunization Dates
  18. Communication/Equipment/Other Needs

Instructions for filling out the card: