The Santa Clara County Fire Department sponsors a Vial of Life program, along with the Stanford Outpatient Pharmacy.
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 sticker and obtain information from the Vial.
This kit contains:
A Medical Information Form
A vial to store the form and any advanced directives you may have. Store the vial on the top shelf in the door of your refrigerator.
Two stickers: One is already on the vial. Place the other on the upper outside corner of your refrigerator.
Please take the time to complete the Medical Information Form with current information. Fill out the form COMPLETELY and write the information IN PENCIL, and IN ENGLISH. Use pencil so you can keep all of your information up to date.
DO NOT PUT ANY OF YOUR MEDICATIONS INSIDE THE VIAL. The Vial should contain ONLY the Medical Information Form.
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:
Senior Services Program
Office of Community and Patient Relations
Stanford University Hospital
650.723.7167
or
Santa Clara County Fire Department
Public Education Office
408.378.4010 or 1.800.800.1793
You can also download blank Medical Information Forms from the
Forms page. Use ONE vial per household; the vial is large enough to contain several
Medical Information Forms.
You may also call the Senior Services Program number for information about advanced directives or to obtain a Durable Power of Attorney for Health Care Decisions or a Pre-Hospital Do Not Resuscitate form.
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