The purpose of this form is to consolidate your information for First-Responders if they are called.

1. To use, open the Pdf-form in a Pdf reader like most current internet browsers and Adobe PDF Reader. 
2. Enter your information if the shaded boxes.
3. Print the completed form twice.
4. Save the Pdf-form for future changes.

Fill out the Form and print it now.  Do not plan on printing it when the emergency occurs, you will be too busy.

The reason to print the Form twice is to have a copy for the probable two First-Responders teams to arrive (Retama and 911 Responders). 

A common place to store the printed PDF-form is in the Red Envelope in a freezer bag inside your refrigerator.  First-Responders are trained to look there for the Emergency Personal Info.

Update the Pdf-form as prescriptions and medical history change and reprint twice.

Medical Form Personal blank

Medical Form Pet Blank