Free Senior Emergency Info Card — Large Text, Easy to ReadSenior Emergency Info
Create an easy-to-read emergency information card designed specifically for seniors and their caregivers. Every section uses large, high-contrast text so the information is readable at a glance, even for those with vision difficulties. Emergency contacts are displayed at the very top of the card because that is the most critical information first responders need. List medications with dosage, timing, and purpose so caregivers and medical staff can maintain the correct schedule without confusion. Document allergies with clear severity warnings, medical conditions, mobility aids, and dietary restrictions all in one place. Include a daily routine section so substitute caregivers or family members know the preferred schedule for meals, activities, and rest. Add preferred hospital, insurance details, and legal proxy information for situations where medical decisions need to be made. Special instructions cover anything else caregivers need to know. No signup required. Pick a template, enter the details, and print the card or share it digitally with family members and care providers. Family can update the card remotely so information stays current.
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Emergency Contacts
Tariq Al-Rashid(Son)
(413) 555-4200Nadia Al-Rashid(Daughter)
(413) 555-4205Hana Malik(Neighbor (Apt 3A))
(413) 555-3300Khadija Al-Rashid
Born: March 18, 1945
Blood Type: O+
Address
42 Maple Court, Apt 3B Springfield, MA 01103
Allergies
PenicillinSEVERE
ShellfishMODERATE
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Donepezil | 10mg | 8:00 PM | Memory support |
| Lisinopril | 10mg | 8:00 AM | Blood pressure |
| Calcium + Vitamin D | 600mg/400IU | 12:00 PM | Bone health |
| Omeprazole | 20mg | 7:30 AM (before breakfast) | Acid reflux |
Medical Conditions
Early-stage dementia
Hypertension
Osteoporosis
GERD
Mobility Aids
Walker for longer distances, cane around the house
Dietary Restrictions
Low sodium diet. Soft foods preferred. No shellfish.
Daily Routine
7:00 AM - Wake up, morning medications 8:00 AM - Breakfast (oatmeal or eggs, decaf tea) 9:30 AM - Light exercises (seated stretches, 15 min) 10:30 AM - Reading or puzzles 12:00 PM - Lunch, midday medication 1:00 PM - Afternoon rest (1-2 hours) 3:00 PM - Tea and snack, phone calls with family 5:30 PM - Dinner 7:00 PM - Television or music 8:00 PM - Evening medication 9:00 PM - Bedtime routine, in bed by 9:30 PM
Doctor & Hospital
Doctor: Dr. Emily Tran
(413) 555-8800Preferred Hospital: Baystate Medical Center
Insurance & Legal
Insurance: Medicare + AARP Supplement, ID: MED-KR-1945-0318
Legal Proxy: Tariq Al-Rashid (Son)
(413) 555-4200Special Instructions
Gentle reminders work better than corrections. She may repeat questions - answer patiently each time. Loves listening to old Arabic music. Keep front door locked at all times (may try to go for walks alone).
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Everything You Need
Senior Emergency Info comes packed with powerful features.
Extra Large Text
High-contrast, oversized text throughout so every detail is readable for seniors and first responders alike.
Emergency First
Emergency contacts displayed prominently at the top of every card, exactly where medical staff look first.
Medication Schedule
Name, dosage, time, and purpose for every medication so caregivers maintain the correct routine.
Daily Routine Guide
Document the preferred daily schedule so substitute caregivers can provide consistent, comfortable care.
Choose Your Template
Emergency Contacts
Tariq Al-Rashid(Son)
(413) 555-4200Nadia Al-Rashid(Daughter)
(413) 555-4205Hana Malik(Neighbor (Apt 3A))
(413) 555-3300Khadija Al-Rashid
Born: March 18, 1945
Blood Type: O+
Address
42 Maple Court, Apt 3B Springfield, MA 01103
Allergies
PenicillinSEVERE
ShellfishMODERATE
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Donepezil | 10mg | 8:00 PM | Memory support |
| Lisinopril | 10mg | 8:00 AM | Blood pressure |
| Calcium + Vitamin D | 600mg/400IU | 12:00 PM | Bone health |
| Omeprazole | 20mg | 7:30 AM (before breakfast) | Acid reflux |
Medical Conditions
Early-stage dementia
Hypertension
Osteoporosis
GERD
Mobility Aids
Walker for longer distances, cane around the house
Dietary Restrictions
Low sodium diet. Soft foods preferred. No shellfish.
Daily Routine
7:00 AM - Wake up, morning medications 8:00 AM - Breakfast (oatmeal or eggs, decaf tea) 9:30 AM - Light exercises (seated stretches, 15 min) 10:30 AM - Reading or puzzles 12:00 PM - Lunch, midday medication 1:00 PM - Afternoon rest (1-2 hours) 3:00 PM - Tea and snack, phone calls with family 5:30 PM - Dinner 7:00 PM - Television or music 8:00 PM - Evening medication 9:00 PM - Bedtime routine, in bed by 9:30 PM
Doctor & Hospital
Doctor: Dr. Emily Tran
(413) 555-8800Preferred Hospital: Baystate Medical Center
Insurance & Legal
Insurance: Medicare + AARP Supplement, ID: MED-KR-1945-0318
Legal Proxy: Tariq Al-Rashid (Son)
(413) 555-4200Special Instructions
Gentle reminders work better than corrections. She may repeat questions - answer patiently each time. Loves listening to old Arabic music. Keep front door locked at all times (may try to go for walks alone).
Created with SimplyOnline.ai
Home Care InfoUse Template
Emergency Contacts
Linda Chen(Wife)
(503) 555-6100Michael Chen(Son)
(503) 555-6105Grace Chen-Park(Daughter)
(206) 555-7200Robert Chen
Born: July 22, 1940
Blood Type: A+
Address
Sunrise Senior Living, Room 214 85 Oak Ridge Drive, Portland, OR 97201
Allergies
Sulfa drugsSEVERE
LatexMODERATE
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Warfarin | 5mg | 6:00 PM | Blood thinner (atrial fibrillation) |
| Metoprolol | 50mg | 8:00 AM and 8:00 PM | Heart rate control |
| Furosemide | 40mg | 8:00 AM | Fluid retention |
| Potassium Chloride | 20mEq | 8:00 AM | Potassium supplement |
| Eye drops (Timolol) | 1 drop each eye | 8:00 AM and 8:00 PM | Glaucoma |
Medical Conditions
Atrial fibrillation
Congestive heart failure (stable)
Glaucoma
Hearing loss (bilateral)
Mobility Aids
Wheelchair for long distances. Can walk short distances with walker.
Dietary Restrictions
Low sodium, fluid restricted (1500ml/day). No grapefruit (Warfarin interaction).
Daily Routine
7:00 AM - Wake up, morning medications 7:30 AM - Breakfast in dining room 9:00 AM - Physical therapy (Mon/Wed/Fri) 10:00 AM - Social activities in common room 12:00 PM - Lunch 1:30 PM - Afternoon rest 3:00 PM - Visitors / reading 5:00 PM - Dinner, evening medications 7:00 PM - Television 9:00 PM - Bedtime
Doctor & Hospital
Doctor: Dr. Laura Bennett
(503) 555-2200Preferred Hospital: OHSU Hospital
Insurance & Legal
Insurance: Medicare Part A & B + Medigap Plan G, ID: MED-RC-1940-0722
Legal Proxy: Linda Chen (Wife)
(503) 555-6100Special Instructions
Wears hearing aids (both ears) - speak clearly and face him when talking. INR blood test every 2 weeks for Warfarin monitoring. Fall risk - ensure call button is within reach at all times.
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Assisted Living CardUse Template
Emergency Contacts
Hassan Osman(Husband)
(512) 555-8900Fatima Osman-Ali(Daughter)
(512) 555-8905Amina Osman
Born: November 5, 1950
Blood Type: B-
Address
18 Birch Lane Austin, TX 78701
Allergies
MorphineSEVERE
AspirinMODERATE
Adhesive tapeMILD
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Metformin | 1000mg | 8:00 AM and 6:00 PM | Type 2 diabetes |
| Amlodipine | 10mg | 8:00 AM | Blood pressure |
| Atorvastatin | 40mg | 9:00 PM | Cholesterol |
| Gabapentin | 300mg | 8:00 AM, 2:00 PM, 9:00 PM | Nerve pain |
Medical Conditions
Type 2 Diabetes
Hypertension
Peripheral neuropathy
High cholesterol
Chronic lower back pain
Mobility Aids
Cane for walking, especially on uneven surfaces
Dietary Restrictions
Diabetic diet. Limited sugar intake. Small frequent meals.
Doctor & Hospital
Doctor: Dr. James Richardson
(512) 555-3400Preferred Hospital: Dell Seton Medical Center
Insurance & Legal
Insurance: Medicare + United Healthcare Supplement, ID: UHC-AO-2026-1105
Legal Proxy: Hassan Osman (Husband)
(512) 555-8900Special Instructions
NO MORPHINE - use alternative pain management. Can use acetaminophen, tramadol (low dose), or nerve blocks. Check blood sugar before administering any IV fluids with dextrose. Bring glucose meter to all appointments.
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Hospital Visit CardUse Template
Emergency Contacts
David Johnson(Son)
(619) 555-3300Susan Johnson-Park(Daughter)
(858) 555-4400Maria Gonzalez(Neighbor)
(619) 555-5500Margaret Johnson
Born: May 12, 1938
Blood Type: AB+
Address
7 Sunset Drive San Diego, CA 92101
Allergies
CodeineSEVERE
StrawberriesMODERATE
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Levothyroxine | 75mcg | 6:30 AM (empty stomach) | Thyroid |
| Losartan | 50mg | 8:00 AM | Blood pressure |
| Calcium carbonate | 500mg | 12:00 PM and 6:00 PM | Bone density |
| Melatonin | 3mg | 8:30 PM | Sleep |
Medical Conditions
Hypothyroidism
Hypertension
Osteoporosis
Mild hearing loss (right ear)
Mobility Aids
Walker at all times. Grab bars installed in bathroom.
Dietary Restrictions
No strawberries. High protein diet recommended. Ensure adequate calcium intake.
Daily Routine
6:30 AM - Thyroid medication (30 min before breakfast) 7:00 AM - Wake up, bathroom assistance 7:30 AM - Breakfast (high protein: eggs, yogurt, toast) 8:00 AM - Morning medications 9:00 AM - Morning walk with walker (15 min in garden) 10:00 AM - Reading, crossword puzzles 12:00 PM - Lunch, midday calcium 1:00 PM - Afternoon nap (1 hour) 2:30 PM - Television or craft activities 4:00 PM - Light snack, tea 5:30 PM - Dinner, evening calcium 7:00 PM - Phone calls with grandchildren 8:30 PM - Melatonin, bedtime routine 9:00 PM - In bed
Doctor & Hospital
Doctor: Dr. Amir Rashid
(619) 555-7700Preferred Hospital: UC San Diego Medical Center
Insurance & Legal
Insurance: Medicare + Blue Shield Supplement, ID: BS-MJ-1938-0512
Legal Proxy: David Johnson (Son)
(619) 555-3300Special Instructions
Levothyroxine MUST be taken on empty stomach, 30 minutes before eating. She is independent but needs standby assistance for bathing and dressing. Loves gardening - let her tend to plants on the patio. Speak on her left side (better hearing).
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Caregiver ReferenceUse Template
Emergency Contacts
Salma Nasser(Wife)
(303) 555-4100Karim Nasser(Son)
(303) 555-4105Layla Nasser-Ahmed(Daughter)
(720) 555-6200Ibrahim Nasser
Born: September 1, 1942
Blood Type: A-
Address
Memory Care Unit, Room 108 Golden Years Residence 200 Valley View Road, Denver, CO 80201
Allergies
IbuprofenMODERATE
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Donepezil | 10mg | 8:00 PM | Memory (Alzheimer's) |
| Memantine | 10mg | 8:00 AM and 8:00 PM | Memory support |
| Sertraline | 50mg | 8:00 AM | Mood stability |
| Tamsulosin | 0.4mg | 9:00 PM | Prostate |
Medical Conditions
Alzheimer's disease (moderate stage)
Benign prostatic hyperplasia
Depression (managed)
Mobility Aids
Can walk independently but may become disoriented. Escort for outdoor areas.
Dietary Restrictions
Finger foods preferred (difficulty with utensils). Thickened liquids. No hard foods (choking risk).
Daily Routine
7:30 AM - Wake up with gentle guidance 8:00 AM - Breakfast (finger foods), morning medications 9:30 AM - Structured activity (music therapy Mon/Wed, art Thu) 11:00 AM - Guided walk in courtyard 12:00 PM - Lunch 1:00 PM - Quiet time in room 2:30 PM - Social time in common area 4:00 PM - Snack 5:30 PM - Dinner 7:00 PM - Calm activities (looking at photo albums) 8:00 PM - Evening medications, bedtime routine 8:30 PM - In bed
Doctor & Hospital
Doctor: Dr. Patricia Chen
(303) 555-9100Preferred Hospital: UCHealth University of Colorado Hospital
Insurance & Legal
Insurance: Medicare + Humana Gold Plus, ID: HUM-IN-1942-0901
Legal Proxy: Salma Nasser (Wife)
(303) 555-4100Special Instructions
Responds best to calm, familiar voices. May not recognize family members - introduce yourself each visit. Loves looking at family photo album (in nightstand drawer). Becomes agitated in crowds or loud environments. If upset, play classical Arabic music (playlist on tablet in room). Do NOT argue or correct - redirect gently.
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Memory Care InfoUse Template
Emergency Contacts
James Williams(Son)
(312) 555-6600Carol Williams(Daughter-in-law)
(312) 555-6601Rosa Martinez(Neighbor (Unit 2))
(312) 555-7700Dorothy Williams
Born: December 10, 1947
Blood Type: O-
Address
55 Elm Street, Unit 1 Chicago, IL 60601
Allergies
AmoxicillinMODERATE
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Acetaminophen | 500mg | 8:00 AM and 2:00 PM and 8:00 PM | Arthritis pain |
| Alendronate | 70mg | Sunday morning, empty stomach | Osteoporosis |
| Vitamin D3 | 2000 IU | 12:00 PM | Bone health |
| Duloxetine | 30mg | 8:00 AM | Pain management / mood |
Medical Conditions
Severe osteoarthritis (both hips, right knee)
Osteoporosis
Right hip replacement (2023)
Fall history (2 falls in past year)
Mobility Aids
Rollator walker at all times. Wheelchair for distances over 100 feet. Grab bars in bathroom. Shower chair.
Dietary Restrictions
No dietary restrictions. Encourage calcium-rich foods. Adequate hydration (8 glasses water daily).
Daily Routine
7:30 AM - Wake up, take pain medication 8:00 AM - Breakfast, morning medications 9:00 AM - Gentle exercises (physical therapist visits Tue/Thu) 10:30 AM - Rest and reading 12:00 PM - Lunch 1:00 PM - Afternoon rest 3:00 PM - Short walk with rollator (around apartment) 4:30 PM - Television or knitting 6:00 PM - Dinner 8:00 PM - Evening pain medication 9:30 PM - Bedtime
Doctor & Hospital
Doctor: Dr. Raj Kapoor
(312) 555-5500Preferred Hospital: Northwestern Memorial Hospital
Insurance & Legal
Insurance: Medicare + AARP United Healthcare, ID: UHC-DW-1947-1210
Legal Proxy: James Williams (Son)
(312) 555-6600Special Instructions
HIGH FALL RISK - always use walker, never rush. Must sit down before reaching for anything above shoulder height. Alendronate (Sunday only) must be taken on empty stomach with full glass of water, remain upright for 30 min after. Physical therapist: Sarah Thompson (312) 555-8800.
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Mobility AssistanceUse Template
Emergency Contacts
Rania Bakri(Wife)
(206) 555-8100Samir Bakri(Son)
(206) 555-8105Dina Bakri-Hamid(Daughter)
(425) 555-6200Ahmad Bakri
Born: February 28, 1944
Blood Type: B+
Address
312 Pine Avenue Seattle, WA 98101
Allergies
Contrast dyeSEVERE
PollenMILD
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Insulin Glargine | 18 units | 9:00 PM | Type 2 diabetes (basal) |
| Metformin | 500mg | 8:00 AM and 6:00 PM | Type 2 diabetes |
| Lisinopril | 20mg | 8:00 AM | Blood pressure |
| Cetirizine | 10mg | As needed, spring/summer | Seasonal allergies |
Medical Conditions
Type 2 Diabetes (insulin-dependent)
Hypertension
Mild cognitive impairment
Bilateral cataracts (post-surgery)
Mobility Aids
Independent walker. Uses magnifying glass for reading.
Dietary Restrictions
Diabetic diet. Low carbohydrate, no added sugar. Blood sugar check before each meal.
Daily Routine
7:00 AM - Wake up, blood sugar check 7:30 AM - Breakfast (low-carb: eggs, vegetables, whole grain toast) 8:00 AM - Morning medications 9:00 AM - Morning walk (30 minutes around neighborhood) 10:00 AM - Read newspaper (large print), puzzles 11:00 AM - Blood sugar check 12:00 PM - Lunch 1:00 PM - Afternoon rest 2:30 PM - Visit with friends or family 4:00 PM - Light snack, blood sugar check 5:30 PM - Dinner, evening Metformin 7:00 PM - Television news, family phone call 8:30 PM - Blood sugar check 9:00 PM - Insulin injection, bedtime routine 9:30 PM - In bed
Doctor & Hospital
Doctor: Dr. Karen Lee
(206) 555-3200Preferred Hospital: Virginia Mason Medical Center
Insurance & Legal
Insurance: Medicare + Premera Blue Cross, ID: PBC-AB-1944-0228
Legal Proxy: Rania Bakri (Wife)
(206) 555-8100Special Instructions
Blood sugar logs in blue notebook on kitchen counter. If blood sugar below 70: give orange juice or glucose tablets (in kitchen drawer). If below 50 or unresponsive: call 911. Insulin pen in refrigerator door. IMPORTANT: No contrast dye for any imaging - inform all medical staff before any scan.
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Daily Routine GuideUse Template
Emergency Contacts
Ken Tanaka(Son)
(408) 555-7100Yuki Tanaka-Adams(Daughter)
(510) 555-8200Helen Park(Neighbor and friend)
(408) 555-3300Noriko Tanaka
Born: August 17, 1941
Blood Type: A+
Address
89 Cherry Blossom Lane San Jose, CA 95101
Allergies
NSAIDs (Ibuprofen, Naproxen)SEVERE
Bee stingsMODERATE
Medication Schedule
| Medication | Dosage | Time | Purpose |
|---|---|---|---|
| Eliquis | 5mg | 8:00 AM and 8:00 PM | Blood thinner (stroke prevention) |
| Metoprolol | 25mg | 8:00 AM | Heart rate |
| Escitalopram | 10mg | 8:00 AM | Anxiety |
| Acetaminophen | 500mg | As needed (max 3/day) | Pain relief (NOT ibuprofen) |
Medical Conditions
Atrial fibrillation
Anxiety disorder
Hearing loss (left ear)
Mobility Aids
Independent. Uses reading glasses.
Dietary Restrictions
Avoid foods high in Vitamin K (kale, spinach in large amounts) - interacts with blood thinner.
Daily Routine
6:30 AM - Wake up naturally 7:00 AM - Breakfast, morning medications 8:00 AM - Garden maintenance 10:00 AM - Community center (Mon/Wed/Fri - Tai Chi class) 12:00 PM - Lunch 1:00 PM - Reading or handicrafts 3:00 PM - Walk with neighbor 5:00 PM - Dinner preparation 6:00 PM - Dinner 8:00 PM - Evening medication 9:30 PM - Bedtime
Doctor & Hospital
Doctor: Dr. Michael Torres
(408) 555-4400Preferred Hospital: Stanford Health Care - ValleyCare
Insurance & Legal
Insurance: Medicare + Kaiser Permanente, ID: KP-NT-1941-0817
Legal Proxy: Ken Tanaka (Son)
(408) 555-7100Special Instructions
ABSOLUTELY NO NSAIDS (ibuprofen, naproxen, aspirin) - she is on Eliquis blood thinner and NSAIDs cause dangerous bleeding. Only acetaminophen for pain. If any unusual bleeding, bruising, or blood in stool - call doctor immediately. EpiPen in kitchen drawer for bee stings.
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Family Emergency SheetUse Template
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Home Caregivers
Give home health aides a complete reference card with everything they need for a new client.
Assisted Living
Provide facility staff with a quick-reference card for residents, updated by family members remotely.
Hospital Visits
Bring a complete medical summary to doctor appointments and emergency room visits.
Family Coordination
Keep siblings and extended family informed with a single shared card that stays up to date.
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Frequently Asked Questions
Seniors and emergency responders need to read this quickly. Large, high-contrast text reduces errors and saves critical time.
Yes. Sign in to save the card, then update medications, contacts, or routines anytime from any device.
Yes. The card is designed for clean printing on standard paper. Emergency contacts and allergies are especially prominent.
Yes. Create a separate card for each person with their own unique medical details, contacts, and routines.
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