For seniors on Florida's Nature Coast -- Pasco, Hernando & Citrus counties

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Your one-page emergency info sheet

If there's an emergency, the people helping you need your key facts fast -- your medicines, conditions, and who to call. Fill in the sheet below, print it, and put it where it counts. It's one of the simplest, most useful things you can do.

Last reviewed: August 10, 2026

The short version:

Common questions

Why keep an emergency info sheet?
Responders and ER staff need your medications, conditions, allergies, and contacts fast, and the person may not be able to tell them. An up-to-date sheet on the fridge saves time and prevents dangerous drug interactions.
Where should I keep it?
On the refrigerator (responders look there), in a wallet or purse, and in your hurricane go-bag. Give a copy to your emergency contact and caregiver, and keep a photo on your phone.
What is a "File of Life" or "Vial of Life"?
A free red magnetic pouch some fire departments and senior centers give out for holding this information on the fridge. Ask your fire department or the Elder Helpline.
How often should I update it?
Whenever a medication or doctor changes, and at least once a year -- an easy habit is every hurricane season and at your annual check-up.

Fill in, then print

Write on the boxes below (or print it blank and fill it in by hand), then press Ctrl + P / Cmd + P to print.

Full name
Date of birth
Home address
Emergency contact 1 (name & phone)
Emergency contact 2 (name & phone)
Primary doctor (name & phone)
Pharmacy (name & phone)
Health insurance / Medicare #
Allergies
Medical conditions
Medications & doses
Equipment / mobility aids (oxygen, CPAP, walker...)
Preferred hospital
Advance directive / DNR on file?
Keep it current: update this sheet whenever a medication changes, and once a year. Pair it with a medical alert button so help is one press away, and tuck a copy in your hurricane go-bag.
Please read: Nature Coast Senior Home is an independent guide. This sheet is a convenience for your own use; keep it somewhere safe, since it holds personal health information. We don't collect, store, or see anything you write on this page -- it stays on your printed copy. In an emergency, call 911.