Emergency medical information sheet for a parent

The nurse will ask what medications your parent takes, at what dose, and who prescribed them. Answering "some blood pressure thing, a white pill" is the normal experience, and it is the reason this page exists.

Fill the form in tonight, while nothing is wrong. It takes about twenty minutes, and it is the only thing on this site you can finish in one sitting.

What the ER asks, roughly in order

Triage runs in a predictable sequence. Knowing it tells you what the sheet must hold and in what order.

1. What happened, and when did it start? The one thing only you can answer. Note the time symptoms began, on the way in.
2. Name, date of birth. Identity before anything else.
3. Allergies. Asked early and asked again, because it governs what they can safely give.
4. What medications, at what dose, how often? The question families fail most. Include over-the-counter drugs, supplements, herbal remedies, inhalers, eye drops, patches, and injectables.
5. Past medical problems. Diagnoses, in plain language.
6. Past surgeries, and roughly when. Implanted devices matter here: pacemaker, stents, joints, pumps.
7. Who is the regular doctor? And which specialists.
8. Insurance. Medicare card, supplement or Advantage plan, drug plan.
9. Who decides if the patient cannot? The healthcare agent, and whether documents exist.
10. Are there existing orders? A POLST, a DNR, an advance directive.

Steps three and four are where an accurate sheet changes the care rather than the paperwork. Steps nine and ten are where it changes what happens if the visit goes badly.

The one-page sheet

Copy this, fill it in, print it. Keep it to one side of one page, because a two-page document gets separated.

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EMERGENCY MEDICAL INFORMATION Last updated: ________________

Patient Full legal name, date of birth, address, phone, preferred language, weight.

In an emergency, contact

1. Name, relationship, phone.
2. Name, relationship, phone.

Healthcare decision-maker Name, relationship, phone. Healthcare power of attorney on file: yes / no. Where the document is kept.

ALLERGIES Drug, and what the reaction is. Write "No known drug allergies" if that is the case, rather than leaving it blank, because blank reads as unknown.

MEDICATIONS

Medication	Dose	How often	What for	Prescriber

Include over-the-counter drugs, vitamins, supplements, inhalers, eye drops, patches, injectables, and anything taken only as needed. Put blood thinners at the top, since they change what can be done immediately.

MEDICAL CONDITIONS Diagnoses, roughly by importance. Note anything that affects an exam: dementia, hearing loss, low vision, non-verbal, seizure history, diabetes.

SURGERIES AND IMPLANTED DEVICES Procedure and year. Pacemaker or defibrillator with manufacturer if known. Joint replacements. Ports, shunts, pumps.

DOCTORS Primary care: name, practice, phone. Specialists: name, what for, phone. Preferred pharmacy with phone. Preferred hospital or health system.

INSURANCE Medicare number, supplement or Advantage plan and member number, drug plan, any secondary coverage.

ADVANCE CARE DOCUMENTS Advance directive: yes / no, where kept. Healthcare power of attorney: yes / no, where kept. POLST or portable medical order: yes / no, where it physically is. DNR: yes / no. Currently enrolled in hospice or palliative care: yes / no, agency name and after-hours number.

BASELINE One or two lines on what this person is normally like. Walks with a cane, lives alone, oriented and conversational, usually knows the date. The most undervalued field on the sheet, because a clinician who has never met your parent cannot tell what is new and what is Tuesday.

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Where it has to live

One copy is not a plan. Put it in all of these.

On the refrigerator. The conventional spot, and responders do look. Some areas distribute a "File of Life" or vial-of-life kit for this, and any bright envelope works as well.

In your wallet and theirs. Folded, in a card slot. This is the copy that exists when the emergency happens at the grocery store.

On both phones as Medical ID. On iPhone: the Health app, your profile, then Medical ID, and turn on Show When Locked. Apple's documentation is explicit:

Medical ID helps first responders access your critical medical information from the Lock screen, without needing your passcode.

On Android: the Safety app, or Settings under "Safety and emergency", with the equivalent show-when-locked toggle. Samsung follows the same pattern from Settings. A responder reaches it from the lock screen by tapping Emergency, then the medical information.

Set it up on your parent's phone and on your own, which is also where your parent should appear as your emergency contact.

In shared cloud storage, or emailed to yourself. So it exists when you are the one travelling, and so a sibling can reach it.

With the POLST, if there is one. A portable medical order has to be physically present to be followed. A POLST filed neatly in a drawer is a POLST nobody sees. See the POLST form.

Keeping it current

A sheet listing last year's medications is worse than no sheet, because it gets believed.

• Update after every hospital discharge, which is when medications change most.
• Update after any new prescription or dose change.
• Set a recurring reminder, and write the update date at the top.
• Bring it to routine appointments and ask the nurse to check it against their list. Two minutes, and it routinely surfaces a discrepancy worth finding in a clinic rather than in a resuscitation bay.

What it does not do

It does not give you any right to hear something back. Handing information over is always allowed. Getting information out of a provider is a separate question, governed by whether a document names you.

Under 45 CFR § 164.510(b), a provider may share information directly relevant to your involvement in care if the patient agrees, does not object when given the chance, or, when the patient cannot say, if the provider judges it in their best interest. That permission is real, and it is permissive rather than mandatory, so it evaporates with a cautious clinician. The reliable answer is a HIPAA authorization signed in advance.

It also does not make decisions. If your parent cannot speak for themselves, who decides comes from a healthcare power of attorney, or, absent one, from your state's default surrogate list.

And it is not a medical order. A POLST is signed by a clinician and directs treatment. A sheet is information. See what documents aging parents need for how these fit together.

The night it actually happens

Take the sheet. Take the phone charger. Take their glasses and hearing aids, because a parent who cannot see or hear presents as more confused than they are, and that changes how they get assessed.

Write down the time symptoms started before you leave.

Ask, at some point, which of the home medications are being continued in hospital. Unintentional gaps at admission are common, and you are the one holding the list.

If your parent is on hospice, call the hospice first rather than going to the emergency department. That is what the 24-hour line is for, and care obtained outside the hospice for the terminal condition can create a bill the benefit will not cover. See what does hospice actually provide.

And if the person carrying all of this is you, caregiver fatigue is about the cost of that job.

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If They Go In Tonight has this sheet as a printed page, along with the document locator, the after-hours numbers, and a page for dividing the work between siblings, so the folder that goes out the door is already assembled. See what is inside