Use this Vial of L.I.F.E. form to assist emergency responders with your medical care. Review at least twice a year to ensure that the information is accurate and up to date. (review it when we change to Daylight Savings Time and when we switch to Standard Time).

List your medications, the dosage, and the normal time of day you take it.

Be specific about your medical conditions - go ahead and write in the blank spaces on the form if you need to. For Example - if you check the Heart box in the center of the form, add in what the exact nature of the heart problem is, i.e. previous heart attack, angina, congestive heart failure, etc.

Keep the vial in the door of your refrigerator on the top shelf, in front of any food items. Make it easy to find!

If you have any questions regarding the Vial of L.I.F.E. program, please contact us at 415-878-2690.