JOHNSON CITY TEXAS VOLUNTEER FIRE DEPARTMENT

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MEDICAL PROFILE FORM

We recommend that you prepare and store a brief medical profile for yourself just in case you become incapacitated and can't speak for yourself.  This critical information concerning your medical history, medications and allergies can be lifesaving when emergency medical personnel respond to you, whether at home, in the hospital or at an accident. 

You should carry a copy of this in your wallet/purse, in the glove box of your vehicles, and in a Vial of Life container (see Vial of Life in the Public Information section above).

Click Form for a blank form that you can reproduce or print out.

It is very important to print all information as clearly as possible.  Consult with your Doctor if you are unable to answer specific medical questions on the form.  Have your doctor review your form for completeness and accuracy. Be sure to update the form as soon as your information changes.

If you have any questions or wish to request a Vial of Life package, please contact the NBCEMS (see Contacts section above).

Form Developed and Instructions Written By:  George Cofran, BS, MBA, Paramedic

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This site designed & maintained by Cofran & Associates, Inc.   Copyright 2007   All rights reserved.
Email: GeorgeCofran@Cofran.com   Web: www.Cofran.com   281-300-7177