File of Life Emergency ID Form
Fill out the form below to provide necessary medical information for emergency personnel. When finished, click "Submit". You will then be able print out the resulting document and keep in an easy to remember location.
Do NOT return this form to us but keep handy in an easy to find location such as on the refrigerator or bedside. This form works best if filled out legibly and in advance of the emergency or non-emergency request. This form should be reviewed at least every six months. Keep in the residence.
Use this form:
- as a way to provide personal medical care information to EMTs, Paramedics, Police and/or Firefighters when they respond to your home as part of a 9-1-1 call, or
- to provide information to EMS providers when they will be transporting a patient from a private residence to a medical appointment, hospital or other procedure in a non-emergency setting.
Please call (860) 647-9798 x 249 for more information.