Free Printable Home Medical Equipment Emergency Information Sheet
A free printable emergency information sheet for organizing important home medical equipment, supplier contacts, power or backup notes, device card or manual locations, medications, allergies, doctors, and caregiver contacts.
This may be called a DME emergency information sheet, home equipment face sheet, medical supply checklist page, power backup notes page, or caregiver equipment handoff.
No signup is required to download the printable PDF.
The main emergency information sheet download stays separate.
Home Medical Equipment emergency information sheet preview
Who it helps
People using home medical equipment, durable medical equipment, oxygen equipment, CPAP or BiPAP, wheelchairs, hospital beds, infusion pumps, monitoring devices, feeding supplies, or other home supports, plus families and caregivers.
Why this can matter in an emergency
A caregiver, family member, home health aide, urgent care team, ER team, school caregiver, or travel companion may need to find equipment names, supplier contacts, device card locations, manual locations, power needs, and backup notes quickly.
A concise sheet may help someone locate the right contact or document without searching through multiple folders, labels, and supply areas.
Home equipment handoff notes
These notes can help someone find equipment details, contacts, and official instructions. Avoid operation steps, troubleshooting, oxygen or ventilator guidance, medication instructions, or treatment decisions.
Which equipment is essential for daily routines and where it is usually kept
Which supplier or DME company manages each item and where the paperwork is stored
Where backup batteries, chargers, supply boxes, manuals, or device cards are kept if the family chooses to share that location
Who knows the current setup and where clinician-provided equipment instructions are kept
Whether communication, mobility, hearing, vision, age-related, or caregiver support needs may affect a handoff
Where to keep it
Keep copies near the equipment area, in a caregiver binder, in a power-outage folder, in a travel bag, with home health notes, or with a trusted family member.
Tell trusted caregivers and family where the current sheet, manuals, device cards, supply documents, and care-plan documents are kept.
When to update it
Review the sheet when equipment, supplier contacts, device cards, manual locations, power or backup notes, supply locations, doctors, medications, allergies, caregiver contacts, or emergency contacts change.
It may also be worth reviewing after new equipment arrives, after a hospital discharge, before travel, before storm season, or when a new caregiver starts.
Privacy and safety notes
Share only what is useful for emergency organization. Avoid putting passwords, full account numbers, financial details, door codes, or unnecessary sensitive details on a visible copy.
This page is for organization and emergency preparedness only. It is not medical advice and does not replace 911, EMS, clinicians, equipment labels, device cards, manuals, device instructions, oxygen prescriptions, ventilator instructions, medical records, medication labels, care plans, discharge instructions, supplier guidance, or patient portals. Do not use it to operate, troubleshoot, adjust, repair, or replace equipment.
Printable sheet versus digital emergency profile
A digital YourEMR profile may help when equipment, vendor contacts, power notes, medications, allergies, doctors, or caregiver contacts change. It can be updated, printed again, or shared through an emergency QR link.
Helpful terms families may hear
DME: Durable medical equipment, such as certain home medical devices and equipment used for care.
Supplier: The company or vendor that provides equipment, supplies, service, or replacement paperwork.
Device card: A card or document with device information that may need to be shown or located quickly.
Backup power notes: Preparedness context about chargers, batteries, or where the official plan is kept.
Manual location: Where the official device manual or manufacturer instructions are stored.
Caregiver handoff: Short notes that help another trusted person find equipment contacts, supplies, and official documents.
Home Medical Equipment details to record
Helpful details may come from equipment labels, DME paperwork, device cards, supply records, care plans, medication lists, or caregiver notes.
Important home medical equipment, such as oxygen equipment, CPAP, BiPAP, nebulizer, wheelchair, walker, hospital bed, lift, feeding pump, infusion pump, suction, monitoring device, or other equipment if applicable
Supplier, DME company, vendor, pharmacy, home health, manufacturer support, or equipment service contacts
Power needs, backup battery location, charger location, manual location, device card location, and where official instructions are kept
Doctors, specialists, medications, allergies, emergency contacts, caregiver contacts, and decision-maker contact if applicable
Home, school, travel, evacuation, or power-outage notes as preparedness context without device-management instructions
Related YourEMR resources
Use these related YourEMR pages when they fit the person's situation.
Helpful home medical equipment and preparedness resources
These outside resources are for general education and preparedness only. Always follow the person's clinicians, device instructions, equipment labels, supplier guidance, medication labels, and care plan.
These free sheets are informational organization tools only. They are not medical records, diagnosis tools, treatment plans, medical advice, or legal advice, and they do not replace 911, EMS, clinicians, medical records, medication labels, device manuals, care plans, patient portals, or professional guidance.
