Emergency Information Form

The American Academy of Pediatrics and the American College of Emergency Physicians have created an emergency information form specifically for children with special health care needs.

Children with special needs frequently require emergency care for acute life-threatening complications that are unique to their chronic conditions. Emergency hospital and pre-hospital care can be negatively affected by a lack of accurate and timely information about the child's special needs and particular histories. This new form will help ensure that a child's complicated medical history is concisely summarized and available in an emergency.

Copies of the completed form can be kept at home, at school, with relatives, with those providing transportation, and with caregivers. A copy of the emergency information form is available on the internet at www.acep.org, or you may call 800/766-2223x56905 and request a paper copy of the form.

last modified: March 2000


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