Epilepsy Wallet Card

Keep your Epilepsy Medical Information Card with you to help first responders in case of an emergency. It's free, fast and there's no registration! Simply fill in the form and print. Your data will not be stored or shared with anyone!

Be safe and carry an In case of emergency wallet card with you to inform first responders, paramedics, doctors, teachers, even friends of your special medical conditions in the event of an emergency. Your information is vital and can help you get the assistance and treatment you need in the event you may not be able to talk or respond. Plus this card contains your emergency contacts information, so your loved ones can be notified in the event of an emergency.

Print Your Epilepsy Medical Information Card Free

The Epilepsy Medical Information Card is a personalized printed card, so you don't have to worry about your handwriting. Fill in the form below, and it will be converted into your own printable PDF file. Simply cut out the card, fold on dotted line and put it into your wallet. The card will provide first responders with your name, date of birth, medical condition, allergies, medications, emergency contacts, physicians, preferred hospital and your home address.

This Epilepsy Medical Information Card measures 3 3/8 x 2 1/8 inches when folded, the same size as a credit card.

Emergency Medical ID Wallet Card Sample Image

Take a look ...

Creating your personalized epilepsy information card is easy. Simply fill out the form below and click the create identificaton card button to view the sample PDF.

Take a look at a sample epilepsy information card by clicking the button below.

Click To View Sample Epilepsy Information Card

Error: Your personal information is safe, secure and never stored or shared with anyone!

About You
Enter your Name, Address and Birthday.

Your Name (Required)

Date of Birth (Required)

Street Address

City

State

Zip

Physician Information
Enter your physician contact information below.

First Name

Last Name

Phone Number

Preferred Hospital
Enter your preferred hospital information below.

Hospital Name

Emergency Contacts
List the people that should be contacted during an emergency.

Contact Person One

First Name

Last Name

Relationship

Phone

Contact Person Two

First Name

Last Name

Relationship

Phone

Existing Medical Condition(s)
Medical Conditions/Medical Devices (e.g. Coronary Artery Disease, Pacemaker, Diabetic, etc...)

Line 1

Line 2

Line 3

List Medications and/or supplements
(e.g. Altace 2.5mg 1XDay, etc.)

Line 1

Line 2

Allergies/Other Info.
Medications/Anything to which you are allergic.
Allergies (e.g. Penicillin, Bee Stings) Other Info. (e.g. Organ Donor, Living Will, Consent to treat, etc).

Line 1

Line 2

Your personal information is never stored or shared with anyone, ever!
What you enter is strictly used to generate your Epilepsy Medical Information Card.