Apply for a Health Card

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How To Apply For A Medical Card

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Hospital emergency room personnel often experience situations where the patient can not give vital health information. Health information placed in the health card would prove to be invaluable to health personnel in providing care.


Complete the health card form to generate your own cards. After the health card form is completed, simply cut along the outline and fold in half to carry in your wallet or purse.

You can update the health card when and if the health card information changes. Please complete the card and print the card.

The health card will last for a extended period of time when you should laminate the card.

To generate the health card, fill out the requested information, and press print.

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The health card will not be stored for any purpose.

Full Name :

Tel:

SS #:

DOB:

Relatives:

Tel:

Doctor:

Tel:

Insurance Company:

Policy #:

Blood Type: A B AB O

Rh Factor:Plus Minus


Existing Health Problems:

Colonoscopy: Cancer:

Other stuff:


Blood Pressure:

Allergies:

drugs that you takes:




Important Note: The health card makes no guarantee to the accuracy of the health card. Any risk arising out of use of the health card remains with the user of the health card.

Many people have had disastrous experiences in the past with bad medical discount cards.

We welcome you with open arms to real health insurance that will accept you for who you are.

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