Template For An Emergency Info Sheet

Print this out and fill in all the necessary information the EMS dispatcher will need to know so that you'll be ready to act quickly and correctly in the event of an emergency.

1. FIRST AID KIT LOCATION ______________________________________________________________________________________________________
AED__________________________________________________________________________________________________

2. EMERGENCY TELEPHONE NUMBERS
(Put a star next to the phone number that should be called first in your area.)

EMERGENCY MEDICAL SERVICES - EMS (911 in the USA/Canada)
_______________________________________________________________________________________________________
FAMILY DOCTOR _____________________________________________________________________________________
FIRE DEPARTMENT ___________________________________________________________________________________
POLICE _______________________________________________________________________________________________
POISON HELP CENTER (1-800-222-1222 in USA)
NEAREST HOSPITAL __________________________________________________________________________________
Directions:
_______________________________________________________________________________________________________

3. WHEN YOU CALL FOR HELP BE READY TO PROVIDE THE FOLLOWING INFORMATION
YOUR NAME __________________________________________________________________________________________
TYPE EMERGENCY ____________________________________________________________________________________
Number Injured _______
LOCATION OF EMERGENCY
_______________________________________________________________________________________________________
Street address/apartment number
_______________________________________________________________________________________________________
Cross streets/nearby landmarks
_______________________________________________________________________________________________________
Major intersections
_______________________________________________________________________________________________________
Telephone number you're calling from

4. DESCRIBE WHAT HAPPENED
You can be given instructions on how to help until EMS arrives. Someone should be available to relay instructions if the emergency is not near a telephone.

5. STAY ON THE PHONE UNTIL TOLD IT IS OKAY TO HANG UP