The purpose of this form is to provide pertinent medical and personal information to health care providers in case of a medical emergency when you are not able to provide this information yourself. This information would be invaluable if you were ever sick or injured. If this information is ever needed by medical personnel be assured that it will be held in complete confidence.

• Fill out one form for each person in the household completely.
• Place the form or forms in a sandwich sized labeled baggie.
• Tape the baggie inside your refrigerator, on either sidewall near the top close to the front where it can be easily seen. Emergency medical personnel will know to look there.

Should it be necessary for you to got to the hospital and emergency personnel are not summoned, it would be very helpful to take this form with you. Update the form, as it becomes necessary.

If you have any questions, please call; (706) 268-3646 or (706) 268-3992. Additional forms can be found in the post office, the Big Canoe 2009 Directory, and on the HOA Website.

Click here to view, download or print the Big Canoe Emergency Medical Form