Have this information posted near telephones or on the refrigerator, where it can be used by anyone in the household in case of emergency.

Personal Information

• Name
• Date of Birth
• Address
• Phone
• SS #
• Supplemental Insurance #
• Medicaid #
• Medicare #
• Current Medications
• Exact Location of Do Not Resuscitate Order

Emergency Numbers

• Fire
• Police
• Ambulance
• Hospital
• Doctor
• Drugstore
  • Open Till
  • Delivers
• Family Caregiver Work Number
• Alternate Caregiver
• Home Health Care Agency
• Medicare Toll Free Number
• Insurance
• Medical Equipment Company
• Poison Control
• Friend
• Neighbor
• Relative
• Clergy/Rabbi
• Transport Number
• Meals-on-Wheels
• Shopping Assistance
• Directions for Driving to the House