Small Envelope $ 24.95 USD, Large Envelope $ 28.95 USD
For Individual, For Multi-Person
$24.85 – $28.95
The EMI Kit Plus provides medical information both Electronically on a USB flash drive for your key ring Hard copy backup to keep handy at home, car or traveling.The USB contains generic blank forms (see below) for you to complete, save to the USB flash drive and print to get signatures and place in the vinyl envelope that is provided.
1 Vinyl Envelope – Small 8″ x 10″ or Large 10″ x 12″
Choice of Front label – Individual ( see EMI page) or Multi-person
for back up hard copies (needed due to power failures)
Choice of vinyl envelopes for backup copies of paperwork
(unfortunately, we do have power failures and you still want to be prepared)
Emergency Medical Summary Form
Additional Medication List
Generic Health Care Proxy form
Generic HIPPA Release form
Small Envelope $24.85
Large Envelope $28.95
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.