Below you’ll find two emergency forms and two pages which can be used as an expansion to the original forms.
These forms have been designed to provide the information you will need to have with you for an emergency visit to a clinic or hospital. We recommend you also take with you a substantial amount of cash and/or a credit card. Remember that you will not be allowed to check out of an hospital or clinic unless you have insurance or have paid the bill.
How to use the forms
- Click the button for the form you’d like to fill out below. This will open the PDF form in a new browser window or tab.
- The forms have been set up to be filled out online which allows you to fill out the information right from your browser before printing it. (Note that the information provided in the form will not be stored anywhere. See below for a way to save a digital version of the form for your records.)
- Alternatively you can print out the blank form and fill out the fields manually.
- If you have additional information or use more medications than the original form allows you to enter, you can use one of the extra pages (lower two buttons) to add to the original form.
Interactive PDF forms are not supported by all browsers. We found that the interactive forms do work on Safari, Chrome and Internet Explorer. On mobile devices with Android or iOS (iPhone/iPad) you’ll need to install a PDF reader like Adobe Acrobat (recommended).
- In case your browser settings don’t allow to open pages in a new window or tab, there should be a notification indicating that this action has been blocked which allows you to give permission.
- If you rather not do the above you can also right-click on either button and select “Save links as” or “Save target as” (or similar). This saves the form to your computer at a location of your choice. From here you can open the file in a PDF reader or in your browser from where you can follow the same steps as above.
- As mentioned before, no information filled out in the forms will be stored. This means that filling out the form and then downloading it will erase everything and you’ll have downloaded an empty form. To give you an option to store a digital copy of the filled out form for your records, select print and then in the section where you can choose a printer select “Save as PDF” (this might differ per browser) which will save the completed form with all data to your computer.
- For your security, when you fill out the form make sure to NOT include sensitive information like credit card details, security codes, bank log in information, etc. You never know who’ll see this form in case of an emergency or online.