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Emergency Medical Alert Card  

 

 

 Hospital Emergency Room personnel often experience situations where the patient can not communicate to provide them with vital health information. A medical identification and information card would prove to be invaluable to attending medical personnel in providing treatment.

Once you have attended our Consumer Advisory Association seminar, as a FREE GIFT, you  will may request a personalized Emergency Medical Alert Card which contains:

  • Vital information concerning your health, allergies to medications, prescriptions being taken;
  • The name of an emergency contact;
  • Your physician's name and telephone number;
  • Insurance Information
Sample Card:

 

 

 

 

 

 
Once you have attended our Seminar, please complete the information below and your medical card will be sent to you at the address on your enrollment form.
 

Date Seminar was attended: 

Seminar was held:

Date:                  

Location:            

City:                   

State:                 

 

Medical Information:

Name:                 

Phone:                 

SS#:                     

Date of Birth:     

Please Contact:  

Relationship:      

Phone:                 

Physician:            

Phone:                 

Insurer:               

Policy No.:          

Blood Type:  A   B   AB   O           Rh Factor:  Positive   Negative

Existing Medical Conditions:

Heart Condition:      Diabetes:      Other:

 

Allergic to:        

Medications:     

                          

 

Exclusively from Consumer Advisory Association!