Emergency Contacts and Important Phone Numbers

In case of an emergency where I am unconscious, not breathing, or otherwise injured:

1. Dial 911.

2. Give the emergency operators the following information:

Descrption of Problem

My Name:

Address:

Phone:

Disability or Pre-existing Condition:

3. When you are free, call all of these emergency contacts and inform them about my situation:

Emergency Contact #1:

Phone:

Emergency Contact #2:

Phone:

Emergency Contact #2:

Phone:

4. Provide the attached Emergency Medical Information to emergency personnel or hospital.

Tools > Exit Interview Checklist

This tool is part of InfoUse's Working Together, a website for consumers of personal assistance services. http://www.infouse.com/pas/.

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