Emergency Information Card
Keep this in your wallet, purse, or carry-on while traveling.
Traveler Name: _________________________________________________________________________________________________________________________
Date of Birth: ___________________________________________________________________________________________________________________________
Blood Type (if known):_________________________________________________________________________________________________________________
Allergies / Medical Conditions:_________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
Primary Emergency Contact Name:____________________________________________________________________________________________________
Relationship:___________________________________________________________________________________________________________________________
Phone (with country code):____________________________________________________________________________________________________________
Email____________________________________________________________________________________________________________________________________
Secondary Emergency Contact Name:_________________________________________________________________________________________________
Relationship:___________________________________________________________________________________________________________________________
Phone (with country code):____________________________________________________________________________________________________________
Email:___________________________________________________________________________________________________________________________________
Insurance Provider: ____________________________________________________________________________________________________________________
Travel Assistance Number (if applicable):_____________________________________________________________________________________________
Passport Number:______________________________________________________________________________________________________________________
Country of Issue:______________________________________________________________________________________________________________________
Medications Taken Regularly: _________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
Other Notes (e.g., DNR, Preferred Hospital, Doctor Contact: _________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
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