Emergency Info Card

Print, fill out, and cut along the dotted lines. Keep the wallet cards in your wallet or purse, and post the fridge card in a visible location. These cards ensure that first responders and ER staff have critical information about your GLP-1 medication.

Why GLP-1 Patients Need This Card GLP-1 medications affect gastric emptying, which is critical information if you need emergency surgery (aspiration risk under anesthesia). Some medications interact with GLP-1 drugs. First responders need to know what you are taking to provide safe, appropriate care.

Wallet Cards (Print 2 copies)

Medical Information Card

I am taking GLP-1 medication

Name:

DOB:

Medication:

Dose:

Last Injection:

Prescriber

Name:

Phone:

Pharmacy

Name:

Phone:

Allergies

Other Medications

Emergency Contacts

Contact 1:

Phone:

Contact 2:

Phone:

Medical Information Card

I am taking GLP-1 medication

Name:

DOB:

Medication:

Dose:

Last Injection:

Prescriber

Name:

Phone:

Pharmacy

Name:

Phone:

Allergies

Other Medications

Emergency Contacts

Contact 1:

Phone:

Contact 2:

Phone:

Refrigerator Card

Emergency Medical Information

This person takes GLP-1 injectable medication

Patient Name:

Date of Birth:

Medication:

Dosage:

Injection Day:

Prescriber:

Prescriber Phone:

Allergies:

Other Medications:

Insurance:

Member ID:

Emergency Contact:

Contact Phone: