Vial of Life

The Vial of Life is a personal medical information form that is designed to speak for you when you can’t speak for yourself. The form can assist emergency personnel in administering the proper medical treatment when in need. Click here to download and print the form.

Follow the instructions on the form and complete it to the best of your ability with as much information as possible. Use a pencil so you can update the information as needed. Place the completed form in a vinyl pouch along with any do not resuscitate orders. Affix to your refrigerator/freezer door using the adhesive side of the vinyl pouch.

Other tips regarding the Vial of Life:

  • Forms and pouches are available at Station 31/Headquarters .
  • Make an extra copy and carry it with your when you travel away from home.