Information To Share With Emergency Medical
Personnel and Hospital Staff
Medicines you are taking:
 
 

Medicines you are allergic to:
 
 
How To Contact Your Doctor
If symptoms stop completely in less than 5 minutes, you should still
call your doctor right away.

Phone number during office hours:

Phone number after office hours:
Person To Contact If You Go to the Hospital
Name:

Home phone number:

Work phone number:

Cell phone number: