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Health and medical records · HM-217 · Form

Emergency Medical Information Card

Free printable emergency medical card — contacts, the conditions and medicines you choose to list, allergies and blood group. PDF and browser versions.

First page of the Emergency Medical Information Card printable — who you are and who should be telephoned, in order
Download Free · no sign-up

One page. The A4 and US Letter files are laid out identically, so neither is shrunk to fit.

Print it and write on it

Fillable PDF type and save

Or no download needed

Fill it in online

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

Fill it in online

The same sheet, on screen. Tick, type, add or remove rows, then print it or download the completed version as a PDF. Everything stays in your browser — your entries are kept in this browser's own storage on this device, nothing is uploaded, and there is no account.

Who this is for

One page for somebody else to read when you cannot explain. It carries your name and contacts, the conditions and medicines you decide to put on it, the allergies you have been told to mention and your blood group if you know it — short enough to be taken in quickly and plain enough to be read by anyone.

Anyone who would rather not rely on being able to answer questions, people with a condition worth mentioning early, older relatives and the family holding their paperwork, lone workers and travellers.

What this helps you track

  • Who you are and who should be telephoned, in order
  • The conditions you have chosen to list, in your own words
  • The medicines you take, copied from the labels
  • Allergies and what happens, as you were told to describe them
  • Your blood group, if you have been told it, and where your fuller records are

How to use it

  1. Fill in the top of the card: name, date of birth, address and blood group if you have been told it.
  2. Write two people on the contact lines, in the order you want them telephoned, with their relationship to you and a number that will be answered.
  3. List only the conditions you want somebody to know about — this is your card and nobody else decides what goes on it.
  4. Copy your medicines from the labels, exactly as printed there, and leave out anything you would rather not have on a card in a wallet.
  5. Write your allergies with what actually happens, using the words you were given.
  6. Print it, fold it and keep it where it will be found; update it whenever something changes and put the date on it.

Formats

  • Printable PDF (A4 and US Letter)
  • Fillable PDF with form fields
  • Fill in online, saved in your browser

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Is this an official document?

No. It is a card you write yourself, and it carries no authority. It exists so that somebody who does not know you has somewhere to start, and so that you are not answering questions at the worst possible moment.

Should I put everything on it?

Only what you want on it. A card kept in a wallet can be read by anyone who finds the wallet, so many people list the things that would matter quickly and leave the rest on their fuller record at home.

Does it say what anybody should do for me?

No. There is no instruction, no plan and no treatment on it anywhere. If you have been given a written plan by a clinician, keep the card with it and say so in the notes.

How often should I redo it?

Whenever something on it changes, and put the date in the box so that anyone reading it knows how current it is. An out-of-date card is worse than none.

Can I make one for a relative?

Yes, with their agreement, and write down who filled it in. A card that somebody else wrote is still theirs, and what goes on it is still their decision.

Related resources

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