phone-setup-for-memory-loss/templates/emergency-contact-sheet-template.md

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🚨 Emergency Contact Sheet for [Name]


🏠 Location

You are currently staying at:

Address:
[Steve & Sandra's House Address]
[City, State, ZIP]


📞 Primary Contacts

Name Relationship Phone Number Notes
Steve Son-in-law [Phone Number] Primary caregiver
Sandra Daughter [Phone Number] Lives in same house
[Contact #3] [Relation] [Phone Number]

🚑 Emergency Services

Service Phone Number Notes
Police / Fire / Ambulance 911 In case of immediate danger
Hospital Name [Phone Number] [Address, if useful]
Doctor / GP Name [Phone Number] Primary care physician

💊 Medications & Allergies

  • Known Allergies: [List any allergies]
  • Current Medications:
    1. [Medication 1 Dosage, Frequency]
    2. [Medication 2 Dosage, Frequency]
    3. [Medication 3 Dosage, Frequency]

📄 Important Medical Information

  • Primary Diagnosis / Condition: [Condition, e.g., Short-term Memory Loss due to Hypoxia]
  • Other Medical Notes:
    • [Any important medical history or notes]

🗒️ Additional Notes

[Use this space for any specific instructions, insurance info, or extra reminders.]


Keep this sheet in a visible, accessible place (e.g., on the fridge or near the phone).