Help first responders find important information quickly in an emergency.

A simple medical form and magnetic packet for your refrigerator — one of the first places responders check.

Get Your Free Form See How It Works

Simple & Fast

How It Works

Three quick steps to make sure your critical information is ready when it matters most.

Fill out your form

Complete your emergency medical information — conditions, medications, allergies, and emergency contacts.

Place it in the packet

Slide your completed form into the magnetic emergency packet we provide.

Put it on your refrigerator

Stick the magnetic packet on your fridge where it's easy to find in an emergency.

🧲 The refrigerator is one of the first places first responders may check during a medical emergency.

The Packet

What You'll Receive

A clear, easy-to-read emergency medical form and a durable magnetic packet — completely free and mailed right to your door.

Front and back of the Emergency Medical Form showing fields for personal and medical information — Front & back of the Emergency Medical Form · tap to enlarge

Magnetic emergency packet on the refrigerator — Magnetic packet — ready for your refrigerator

Optional Donation

Help Us Keep This Free

Optional donations help cover product and shipping costs so we can continue providing free emergency medical forms.

Thank you for your support.

Every contribution helps us mail more free emergency medical forms and magnetic packets to families.

Donate

100% optional — your free form and packet are yours regardless.

Free

Enter Your Information Below

Your emergency medical form and magnetic packet are provided at no cost — we'll mail them directly to the address you enter below.

We only need your name and mailing address to send your free emergency medical form and magnetic packet. Fields marked with an asterisk (required) are required.

Your Name

First Name

Last Name

Phone Number (optional)

Mailing Address

Street Address

Apartment, suite, etc. (optional)

City

State

ZIP Code

I agree to the Privacy Policy and Terms of Service, and consent to Financial Health using my address to mail my free packet.

Your information is private and used only to prepare and ship your free emergency medical packet.

A personal note from Jeff Schemansky, owner of Financial Health and a Firefighter and Paramedic, explaining how the packet helps families prepare for medical emergencies.

A Note From Our Sponsor

This packet helps families prepare.

The Emergency Medical Form was made possible by Financial Health — because being ready for an emergency is part of protecting the people you love.

Have questions about life insurance, wills & trusts, medical directives, or power of attorney? Reach out for a complimentary Financial Health Checkup.

Jeff Schemansky

Owner, Financial Health — Firefighter / Paramedic

Call or Text — (586) 371-2312