Medical Information for Medical Emergencies

							                                   Medical Information for Medical Emergencies

 If we ever have a public health emergency where a large number of people need medicine all at the same time, you might not be able to get what you need from your
 doctor. Instead, special locations will be set up to hand out medicine. If this happens, you will be told where to find these places — just watch TV or listen to the radio.

 To make sure you get the right medicine at these places — and the right dose — you should fill out this form and keep it in a safe place where it is easy to find. Update it
 whenever your medical information changes. Then, if we have a public health emergency, you can bring the form with you to help healthcare workers choose the medicine
 that is the best and safest for you and each of your your family members.


 Name of Person         Age/Weight               Medical Condition(s)                              Medications                              Allergies to medications
                    (for children only) (including pregnancy or breastfeeding)                  (currently talking)

1.)




2.)




3.)




4.)




5.)




6.)




7.)




8.)