Honoring the Gift of Heart Health for American Indians
Section Two - Act in Time to Heart Attack Signs!
Act in Time to Heart Attack Signs!
Call 9–1–1 if You Feel Any of These Symptoms of a Heart Attack
My Heart Attack Survival Plan
My Emergency Card
My Emergency Card
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Basic Information
| Name: |
__________________________ |
| Date of Birth: |
__________________________ |
| Home Phone: |
__________________________ |
Emergency Contacts:
(Name, Relationship, Phone) |
__________________________ |
Do you have any of the following conditions?
List current medications, known allergies, and any other information.
| Current medications: |
__________________________ |
| Known allergies: |
__________________________ |
| Other information: |
__________________________ |
Emergency Numbers
| Family Doctor: |
__________________________ |
| Phone: |
__________________________ |
| Local Clinic/Hospital: |
__________________________ |
| Phone: |
__________________________ |
| Fire Department: |
__________________________ |
| Local Police Department: |
__________________________ |
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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
National Institutes of Health
National Heart, Lung, and Blood Institute
NIH Publication No. 08-6340
June 2008
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Department of Health
and Human Services
National
Institutes of Health
National Heart, Lung, and Blood
Institute