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18 Free Tools for Medical and Care Giving

1.  Emergency Medical Information
EVERYONE should fill out this form and give copies to one or more friends or family members and include their name and telephone number on an emergency information card you carry with you at all times. If you have a sudden health emergency (car accident, stroke, heart attack, etc.) it is critical that medical personnel have the information necessary to provide the appropriate care. Emergency personnel won’t search your phone, tablet or other electronic device nor will they use your flash drive, memory stick or similar storage device to locate important medical information because an unknown virus could take down their entire computer system so be sure this essential information is readily available through multiple sources.

2.  Permission to Share General Medical Information with OthersPrivacy laws no longer allow even your spouse access to any of your medical information without your written permission. This form allows you to designate everyone you want to be able to get a general condition status update from hospitals, doctors, hospice, rehab and other facilities where you may be a patient. This is especially important after surgery or in a medical emergency. Fill this form out and give a copy to everyone on the list so they can provide a copy to the appropriate party (in person, via fax, scan and e-mail, etc.) to keep up with your condition.View

3.  Permission for Others to Discuss Your Medical Information with Doctors, Hospitals and Other Medical PersonnelThis Permission only allows those you list to get more detailed medical information from physicians and other medical personnel about your medical situation. It allows you to determine the limits of the medical information to be shared.View

4.  List of People Permitted to Pick Up X-Rays, CT Scans, MRI and All Other Tests ResultsDid you know that even your spouse isn’t allowed to pick up an x-ray, MRI or any other test, medical records, etc. for you from a doctor, hospital or other medical facilities without your written permission? When you are in the midst of significant or lengthy medical treatment or a medical emergency, you need all of the help you can get so fill this out to designate those who have your permission to lend a hand if needed.View

5.  Visitation List for Hospital and Other Medical FacilitiesIf you are hospitalized and are unable to communicate for some period of time, only immediate family members will be allowed to visit you without written permission. Complete this form and give a copy to everyone on the list.View

6.  Permission for Others to Fill, Pick Up and Discuss Prescription Medication with Pharmacist and Related PersonnelPrivacy laws prohibit anyone else from filling your prescriptions or asking the pharmacist or other personnel questions, advice, etc. without your written permission.View

7.  List of People Permitted to Access Private Insurance Information and to Act as Your AdvocateDid you know that even if you get your medical insurance through your spouse’s employer that your spouse isn't permitted to discuss your benefits, reimbursements, costs, etc. or act as your advocate unless you give them written permission? The same is true for any children you have once they turn 18 even though you provide their insurance. The same is true for all types of insurance. If something happens and you are unable to manage your affairs for some period of time, it’s important that one or more people have your permission to have access to your insurance information and can act as your advocate.View

8.  List of People Permitted to Access Government Benefits Information and to Act as Your AdvocateJust as is the case with any private insurance, no one can help you with the benefits, cost, or other matters affiliated with government sponsored benefits like Social Security, Medicare, Medicaid, etc. without your written permission.View

9.  Temporary Care Giving Instructions (Short Term Relief for Primary Caregiver)When you are giving or receiving care from others for some period of time, it’s essential that others have the information and instructions needed to give the primary caregiver a break on a regular basis. This form allows you to easily put that information in writing so any number of other people can provide the breaks on a regular basis.View

10.  Primary, Longer Term Care Giving InstructionsIt’s not only important that the primary caregiver of someone who requires longer term care get more lengthy and regular breaks, but it’s essential to maintain up-to-date written care giving information and instructions in the event that the primary caregiver has their own medical or other emergency or crisis which results in the need for others to assume their responsibilities for some period of time.View

11.  Dietary Instructions, Menu Planning and Medication ScheduleThis form makes it easy for one or more care givers to keep track of the dietary requirements and medication schedule of the person under their care.View

12.  Information Related to Care Giving Services Being Received (Meals on Wheels, Nursing, Meal Preparation/House Cleaning and Other ServicesThe goal for most of us is to be able to stay in our own homes as we age or if we are facing medical and other challenges. The secret to achieving this goal is to get help when needed, whether from friends and family members or from other sources and organizations as it can truly “take a village” to get the assistance we need or to be able to help others. This form allows you to easily keep track of “who does what” which is essential when help comes from multiple sources.View

13.  Nursing Home, Assisted Living and Rehabilitation Facilities Preferences ListThere are many instances when you may have to spend time in one of these facilities as a result of an unexpected event like a car or other accident, stroke, heart attack or other medical emergency until you are well enough to return home. The quality of these facilities can vary significantly and you could find yourself in a really unfortunate situation if you don’t take the time to research the available options in your community and make a written list your preferences so you are prepared for the unexpected.View

14.  Permission for Nursing Home, Assisted Living and Other Facilities to Share Information with OthersJust as with your healthcare, insurance, and other key parts of your life, it’s important that you have an advocate as your backup while residing in any of these facilities so, if needed, they can make certain that you are getting the care you deserve as well as deal with any financial or other issues if necessary.View

15.  Permission for Family Members, Attorneys, Etc. to Share Copies of Healthcare Power of Attorney, Living Will and other Advanced Directives with Others

When the unexpected happens, designated individuals need to be able to provide critical legal and advanced directives to the appropriate parties.View

16.  Healthcare Power of Attorney 

When choosing who to give your healthcare power of attorney to, remember that the person you select should be someone with whom you’ve had a lengthy conversation about what you would want under specific situations if you were unable to make your own healthcare decisions. Not only should they be willing to make the kinds of decisions you would make for yourself if you were able, but these decisions shouldn’t be in conflict with their own personal beliefs.
Living Smart isn’t a legal resource nor does it give legal advice or provide legal documents. However, we believe that every adult should have a healthcare power of attorney so we listed several internet legal firms on the LEGAL RESOURCES page of the website that offer this free document. We are in no way affiliated with these companies nor can we attest to their legal capabilities.

17.  Living Will(Go to “LEGAL RESOURCES” from our Home Page) Please see 16 above.

18.  Power of Attorney(Go to “LEGAL SOURCES” from our Home Page) Please see 16 above.


Although none of the above tools are legal documents, it’s possible that someone may ask you to include a notary with one of the completed forms for their records. Just print out the notary form, attach it to the completed but unsigned forms and take to a notary for you both to sign.  View

  • Today's privacy laws prohibit anyone, even your spouse, from getting access to personal information that may be needed to help in an emergency unless they have your written permission.
  • In a medical emergency, information regarding current prescriptions, any known health conditions, the names of your doctors, known allergies, etc. must be immediately available to medical personnel.
  • Medical personnel won't search your technical devices for medical information nor will medical facilities allow the use of a flash drive or similar device with their computers due to concerns over possible viruses infecting their system.
  • Once your children become 18, you no longer have access to any of their medical, financial, college, insurance or other information without their written permission even if you still provide their insurance and pay some or all of their bills.
  • People who live alone are particularly vulnerable when the unexpected happens unless they have put into writing the information, instructions, and authorizations that allow others to help manage their medical care, finances, household matters, pets, children and all other important components of their life until the emergency passes.

It's easy to create an Emergency Backup Plan for you and your family. Take the following steps to enable you and your family to be better prepared to assist one another when the unexpected happens:

Review the tools and select those that are most appropriate for your life and circumstances. BE SURE TO COMPLETE AN EMERGENCY MEDICAL INFORMATION FORM FOR EACH ADULT AND CHILD IN YOUR FAMILY.

Complete the forms you have chosen. If you completed the forms on your computer, save them on your computer, print out a copy so it can be immediately accessible if needed, and give or email a copy of those forms you want to share with others. If you completed the forms by hand, you may want to scan them so you can save a copy to your computer, iPad, phone or other electronic devices. You may also want to scan any signed, completed forms into one or more of your electronic devices so you'll have a backup copy to the original if needed as well as to make it easier to share with others, including any third parties who require signed authorizations to share information, etc.

Give a copy of the completed forms to those you have chosen to undertake specific responsibilities on your behalf in case of an accident or emergency so they are prepared to immediately follow your directives. For example, give a copy of Pet Care Information and Instructions, Permission for Others to Seek Medical Treatment for your Pets and all other relevant forms to whomever you want to care for your pet(s) in an emergency. When it comes to sensitive financial and similar information, you may prefer to keep that information private unless something happens that requires others to have access to this information. Place this private information in a safe place with your other important papers and tell one or more trusted individuals where this information can be found with instructions to access it only in an emergency or whatever other stipulations you set. If you place the originals of these sensitive forms in a safety deposit box, be sure and keep copies somewhere that can be immediately accessible in an emergency and tell one or more trusted individuals where they can be found.

Complete an Emergency Contact Card and carry it with you in your wallet or billfold so emergency personnel know whom to contact in an emergency. Make certain at least one person named on the card knows where they can find your Emergency Back Up Planner and completed forms so the information, instructions, and authorizations needed to care for you and your life is immediately available until the crisis has passed.

Click Here To Download & Create a Free Emergency Notification Card for Your Wallet 
(Courtesy of Virginia Tech)


  • When selecting individuals to undertake various responsibilities, don't over-burden any one person and make your selections based upon the capabilities of those being selected. For example, the person most appropriate to care for your children, pets, and household responsibilities may not be the best person to oversee your finances, or medical matters. Remember, it's not a popularity contest, make choices based upon the capabilities of the individuals, and their concurrence with the decisions you expect them to make on your behalf.
  • Complete and print out emergency medical information for each family member so it's immediately available in a medical emergency. Most hospitals and medical facilities won't allow you to provide your medical history/information contained in a flash drive, CD, or other USB devices because of their concern viruses could contaminate their network.
  • You may want to give copies of some of your completed forms to those you have chosen to assist you and your family in an emergency. Pick and choose which matters you want to keep private, except in a crisis, and share information and instructions for more practical matters so everyone will know what's expected of them when the unplanned takes place.