Emergency Response Card

Call 911 Police:
  Fire:
  Ambulance:

Information to be given to Emergency Squad

Location/Street Address:__________________________________
City/Town: __________________________________
Directions (cross streets/Landmarks):__________________________________

Telephone Number from where call is made:
__________________________________

What Happened:__________________________________
How many injured:__________________________________
Condition of Injured:__________________________________
Is First Aid being given:__________________________________

DO NOT HANG UP FIRST, LET EMS HANG UP FIRST!


Emergency Response Card

Call 911 Police:
  Fire:
  Ambulance:

Information to be given to Emergency Squad

Location/Street Address:__________________________________
City/Town: __________________________________
Directions (cross streets/Landmarks):__________________________________

Telephone Number from where call is made:
__________________________________

What Happened:__________________________________
How many injured:__________________________________
Condition of Injured:__________________________________
Is First Aid being given:__________________________________

DO NOT HANG UP FIRST, LET EMS HANG UP FIRST!