Vial of Life

The Santa Clara County Fire Department sponsors a Vial of Life program, along with Stanford Hospital.

In an emergency, time is crucial. The Vial of Life kit enables Emergency Responders to quickly locate helpful information regarding your medical history. Emergency Responders, Firefighters, Paramedics and Police are trained to look for the Vial of Life label and obtain critical information from the Vial.

Vial of Life kit contains:

• A Medical Information Form - please complete front and back.
• A Vial to store the medical form and any advanced directives you may have. Store the vial on the top shelf in the door of your refrigerator.
• "Vial of Life" sticker label to place on the upper outside corner of your refrigerator to indicate that the Vial is stored inside your refrigerator.

Please complete the Medical Information Form with current information.
Fill out the form COMPLETELY and IN ENGLISH.
It is critical that you keep all of your information up-to-date.

DO NOT PUT ANY OF YOUR MEDICATIONS INSIDE THE VIAL. The Vial should contain ONLY:

• Medical Information Form
• Advance directive, such as, a Prehospital Do Not Resuscitate (DNR) form. The DNR form must be signed by your doctor.

If you would like additional Vials for family or friends, a new Medical Information Form, or have any questions, please call one of the following numbers:

Santa Clara County Fire Department

Public Education Office

408.378.4010 or 1.800.800.1793

or

Senior Services Program

Office of Community and Patient Relations

Stanford University Hospital

650.498.6312

You can also download a blank Medical Information Form here or from the Forms page. Use ONE vial per household; the vial is large enough to contain several Medical Information Forms.