Next of Kin and Emergency Details Card

2 pages, in this order:

Page 1

Printed under the title: Who to call, who decides, and what somebody arriving cold needs to know — on one page, for one person.

Contacts, not medical instructions. No medical guidance of any kind is printed here, and none should be inferred. This is a contact card. What it records about health is what you choose to write on it, and anybody acting on it should be speaking to your doctor or the emergency services, not reading a printable.

How to use this sheet

1. Fill in one card per person, not one per household.
2. Say plainly who has authority to make decisions, and whether that is recorded anywhere formally.
3. Keep it where somebody would look — with a carer, on a fridge, in a wallet — and think about who else can read it.
4. Date it and check it whenever a number changes.

The person

Write-on lines: Full name · Known as · Date of birth · Address · Phone

Next of kin and contacts — in the order they should be tried

Table, 5 rows: Order · Name · Relationship · Phone · Second phone · Email · Has a key

Page 2

Who to tell, and who decides

Write-on lines: Person with authority to make decisions · Recorded formally? Where · Doctor or practice · Phone · Preferred hospital, if any

Things somebody arriving would need to know

Ruled lines: Access, pets, medication kept where, anything else

Write-on lines: Completed by · Date · Review on