Printable resource

Emergency contact & medical info worksheet

Fill this in and post it on the fridge and by the phone, so anyone — family, a caregiver, or first responders — can find critical information fast. In an emergency, always call 911 first.

Personal & medical information

Full name Date of birth Home address Medical conditions Allergies Current medications (or "see medication tracker") Insurance / Medicare # Preferred hospital

Emergency contacts

Name	Relationship	Phone

Care team

Primary doctor + phone Specialist(s) + phone Pharmacy + phone Home care provider + phone Power of attorney / decision-maker + phone

Pair this with the emergency planning guide and the medication tracker.

Regular check-ins add a dependable human safety net for a loved one who spends time alone.

Take the free assessment Talk with a care advisor