When you go to medical appointments, have tests, or have an emergency, it is very helpful to have a concise document (1-4 pages of info fits 2 easy-to-read double-sided pages) with the most pertinent information that is needed by care providers. Not only does it save time for intake interviews and filling out forms, but it reduces errors and omissions. When carried consistently, it also ensures that emergency staff have the essential information they need, even if an individual is not able to communicate or think clearly (due to unconsciousness or an acute crisis). Medical staff may copy the information pages, insert them in files, or use them to update electronic records. A 14 point font, and the use of bold and/underlined text help draw attention to items of critical importance, such as medication allergies.

The Basics:

Personal details (name, address, date of birth, sex, telephone number, emergency contacts), insurance info, basic medical background (e.g. including bilateral deafness from NF2, multiple brain and spinal tumors, implants/shunts with special instructions for surgery or imaging, allergies, current medications and dosing schedule; specialized info pertaining to seizures/organs/diet/communication access/mobility impairments, “brief surgical history list on reverse side” that lists date, type/brief description, surgeon, hospital, location), and sheet listing main doctors’ and surgeons’ roles and contact info. and admitting hospitals.

* suggestions and examples shared by Dorothy B., Jennette B. and Karen B. were of assistance in developing my document template. Email me for a copy you may use to fill in your own information.

Be sure to update and keep information current!