Information card template 2026

1. Click ‘Get Form’ to open the information card template in the editor.
2. Begin by filling out the 'Patient Information' section. Enter your name, date of birth, address, sex, city, state, and zip code. Ensure all details are accurate for emergency personnel.
3. In the 'Primary Medical Problems' section, provide your doctor’s name and phone number. Indicate your hospital preference and whether you have been a patient there.
4. Complete the 'Health Information' section by listing any allergies to medications and other allergies. Include current medications with their names and doses. Indicate if you have a pacemaker or a POLST.
5. Check any previous medical problems that apply to you in the designated area.
6. Fill out the 'Emergency References' section with names, phone numbers, addresses, and relations of your emergency contacts.
7. Finally, record your vital signs including blood pressure, oxygen saturation, and pulse rate before signing and dating the form.

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