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ER Packet - Laminated Card Re Advance Directives - NM DDPC Resource

ER Packet - Laminated Card Re Advance Directives - NM DDPC Resource

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Published by: National Healthcare Decisions Day on Apr 22, 2011
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04/22/2011

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 Laminated Card (front & back)
Please cut out, fold in half, and place in your wallet and on obvious places at home (onrefrigerator, near telephone, etc. To laminate, just use wide clear tape).
IN CASE OF EMERGENCY
Please contact myHealth Care Power of Attorney
Name: ___________________Ph: _________________ Cell: __________________E-mail: ___________________Back-up: _________________ Ph: _______________Cell: ________________ E-mail: _________________
Y
our name: _____________________________ Address: _________________________________ City _______________ State _____ Zip: _______ Ph: __________________ Cell: _________________ Where to find my Medication List, AdvanceDirectives, Legal Documents, etc.: ______________  _____________ and at ________________________ Medical Insurance Company: _________________ Doctor: ________________ Ph: ________________ 

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