“Having an emergency contact on the outside of the emergency kit is a great idea. Our patient, who had fallen and broke her hip, was really agitated and refusing to go to the hospital.. When we called the emergency number, it was her daughter. She immediately gave us a medication list and then was able to calm her mother. Knowing her daughter would meet her at the hospital, the woman became very cooperative. This saved us time and made our job easier. Thank you.” Bob B, Cambridge, MA

Anyone Who Is:

On medication
Has Chronic health issues
Is disabled
Is a senior
Is a caregiver
Travels a lot

Durable, 12 gauge Magnetic Vinyl envelope
(to hang on the refrigerator)

A COMPREHENSIVE MEDICAL SUMMARY FORM WITH:

Emergency Contact information
Current and Past medical history
Emergency Preparedness checklist
Additional Forms:
Additional Medication List
Generic Health Care Proxy form
Generic HIPPA Release form
Wallet Card

TYPES OF EMERGENCY MEDICAL INFO KITS

Mini Emergency Medical Info Kit

has a single pocketed vinyl envelope with
a front pocket which holds the Emergency
Medical Summary Form, Medication List,
Health CAre proxy and DNR (Do Not
Resusitate) form, if appropriate).

Original Emergency
Medical Info Kit

has a custom designed double pocketed
reclosable vinyl envelope with a front
pocket. The front pocket is for the
information EMS needs and the back
pocket for what the hospital needs.

Electronic Version – USB FLash Drive

For personal use
(most EMS and hospitals will NOT insert
an unknown fl ash drive into their systems)
Flash drive includes blank forms for you to complete
for you, your family and pets

Disclaimer: All paper, chart and/or electronic formats and information are provided for the sole convenience of the user. HD Merrimack makes no warranties or representations about the product or the supplied forms. There may be state specific and physician signed forms the user needs to obtain, not included in the information provided. The forms provided are guidelines only. The user assumes all responsibility for use of this product, including all information the user puts on the forms and the accuracy of said information as well as any documents inserted/not inserted in this product.