Fill in the fields below, then print and post on the fridge.
Living Care Collective
Quick Reference Card — Post on Fridge
911
Emergency
If there is an emergency
1
Call 911Stay on the line and give the address below
2
Call First ContactName and number below
3
Call CoordinatorYour Living Care coordinator below
⚠ Medical Alerts — Tell paramedics immediately
Allergies
DNR on file? Location
Key Medications
Mobility / Other Needs
Person
Full Name
Date of Birth
Home Address
City / Postal Code
Home Access
Entry Method
Code or Key Location
Building Manager + Phone
Language & Communication
Language(s) Spoken
Communication Needs
Care Aid
Name
Agency
Phone
First Contact
Name
Relationship
Mobile Phone
Has Key?
Second Contact
Name
Relationship
Mobile Phone
Physician & Coordinator
Family Physician + Phone
Living Care Coordinator
Coordinator Phone
Additional Notes
Living Care Collective · Print and post on the fridge
lccvancouver.com
Your coordinator will also keep a complete copy of your Emergency Information Sheet on file.