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Emergency Rx: your medical ‘go’ form

Focused on Health - June 2012

emergency "medical information"Hurricane season began June 1. And, if you live in a coastal area, you may have an emergency plan. But, have you also prepared your medical information for evacuation?

Thomas Feeley, M.D., head of the Division of Anesthesiology and Critical Care, remembers the difficulty of piecing together the medical histories and treatment plans of Hurricane Katrina victims back in 2005.

“After our experience with Katrina victims,” Feeley says, “we understand the need for people to add a simple, one-page form to their evacuation kit. It’s just as important as water, flashlights and extra batteries.”

Feeley shares the lessons learned at MD Anderson.

Keep your “go” form updated

emergency "medical information"A patient safety “go” form is a one- or two-page document that includes your medical information. You can create your own “go” form by listing out details about:

  • Medical conditions
  • Past surgeries and hospitalizations
  • Allergies
  • Any significant family medical history
  • Names and contact information for your doctors and pharmacy
  • Insurance information
  • Immunization records
  • Laboratory information or results if you have a complex medical history

With this form, health care workers who are unfamiliar with your medical history have more information to help them decide what care you need.

The form also can help avoid confusion and possible complications in emergency situations, such as being given drugs that may cause an allergic reaction.

Store your completed form in a safe place

  • Make sure your completed form is stored in a waterproof, portable container like a Ziploc bag.
  • Save the completed form on your computer. Even better: keep it on a USB drive that can travel with you.
  • Keep information nearby. In emergency situations, carry your own form, and forms for your children and elderly parents.
  • Keep it updated. Be sure to refresh your “go” form after every doctor’s visit.

While we tend to think these things can’t happen to us, no one is totally safe from disasters like hurricanes, floods, tornadoes or fires. So, it’s best to play it safe and get prepared.

This article is adapted from an article originally featured in MD Anderson’s patient and caregiver publication, Network.

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