Medical Information Form
- Introduction to the Medical Information Form™
- What the Medical Information Form™ Looks Like
- How to Download
- How to Fill Out
- How to Use
How to Use the Medical Information Form™
1. Take a copy of the updated form with you whenever you leave your home and know where your latest version is at all times.
2. Keep a copy in your wallet or backpack.
3. If you live alone have a copy near the most noticeable phone in your home.
4. Have your doctor's staff make a copy of it for your chart.
5. Make sure your pharmacist and dentist also have a current copy.
Space has been left for those who have special needs or who want to list the person named in their Durable Power for Health Care Decisions, a legal document that spells out your wishes about medical treatment if you are unable to speak for yourself.
(completed form will be the size of a credit card)
How to print out the Medical Information Form™
This form is designed to fit onto one page that is folded to the size of a credit card. This document is intended to be printed on both sides (double-sided). It can be used as two pages or printed as a two-sided document. Refer to your printer's manual for directions to print double-sided.
If you don't want to copy the form onto your computer, but want a copy of the blank form click here for a PDF that you can print.