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Fill in as much as you can, then print. Keep one copy on the fridge, one in their bag, one with their main carer. Update it whenever something changes.

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Personal Details

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Emergency Contacts

Tip: List contacts in priority order. Include at least two people who can make decisions and one who lives nearby.

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Medical Team

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Medical Conditions & History

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Allergies & Adverse Reactions

Important: Include medications, foods, latex, contrast dye, and anything that has caused a reaction. Note the reaction type if known.

Type an allergy and press Add or Enter. Include the reaction if known.

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Current Medications

Medication name
Dose
Frequency
What it's for
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Care & Daily Needs

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Legal Documents & Decision-Making

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Current Care Arrangements

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