Get In Case Of Emergency Refrigerator Card Name Address - Www2 Erie

The In Case Of Emergency Refrigerator Card is a vital document that provides essential information about a person’s medical needs and emergency contacts. This guide will help you fill out the form online efficiently, ensuring that all vital details are accurately recorded for use in emergencies.

Follow the steps to fill out the emergency refrigerator card.

1. Click the ‘Get Form’ button to obtain the form and open it in the editing interface.
2. Enter your full name in the section labeled 'NAME'. This should be your legal name as it appears on identification.
3. Fill in the 'DATE CARD COMPLETED' field with the current date when you are completing the card.
4. In the 'ADDRESS' section, provide your current residential address for immediate access.
5. Enter your telephone number in the designated field labeled 'TELEPHONE'. Ensure it is the best number to reach you.
6. List any allergies to medications in the 'ALLERGIES TO MEDS' section. This is crucial for emergency responders.
7. For 'WHOM TO CONTACT NAME & PHONE #', enter the names and phone numbers of three emergency contacts to be reached in case of need. Provide both the name and phone number clearly.
8. Include your date of birth in the designated 'DATE OF BIRTH' field. This helps verify your identity.
9. In the 'DOCTOR’S NAME' section, write the name of your primary healthcare provider.
10. Provide any major illnesses you have in the 'MAJOR ILLNESSES' section.
11. In the 'DOCTOR’S PHONE' field, enter your doctor's contact number for reference.
12. Provide your health insurer details in the 'HEALTH INSURER' field, ensuring all relevant information is included.
13. If applicable, include your Medicare number in the 'MEDICARE #' section.
14. In the 'CURRENT MEDICATIONS' section, list all medications you are currently taking, along with their dosage strength and how often you take them.
15. Finally, once all information is accurately filled out, you can save changes, download, print, or share the completed form as needed.

Complete your emergency refrigerator card online today to ensure your medical information is accessible when it matters most.