Free printable emergency information sheet
Use this medically complex child emergency sheet to help parents and guardians organize key contacts, family-recorded condition summary, baseline status, devices, supplies, care-plan location, school notes, and caregiver handoff details.
This may be called a medically complex child emergency sheet, special healthcare needs emergency information form, parent handoff sheet, school medical summary, or face sheet in some healthcare settings.
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Optional add-on
Add a separate medication list sheet if the main emergency information sheet does not have enough room.
The main emergency information sheet download stays separate.
This sheet can help parents, guardians, home nurses, school nurses, respite caregivers, grandparents, and trusted helpers find a child's parent contacts, baseline notes, care-plan locations, device or supply context, specialists, and emergency contacts without relying on memory.
For a medically complex child, 'normal' may look different from child to child. The printable can help parents record what is typical for their child, where the current care plan is kept, and which parent, guardian, clinician, school, or supply contact can confirm details.
Helpful details may include parent or guardian contacts, diagnoses or condition summary as family-recorded information, baseline status, allergies, medication-list location, device and supply locations, feeding plan location, airway notes, seizure action plan location if applicable, specialists, primary doctor, pharmacy, DME or supply company, home nursing agency if applicable, school contacts, hospital preference, and emergency contacts.
If airway equipment is part of the child's care, see the trach and airway emergency information sheet . If seizures are part of the child's history, see the seizure and epilepsy emergency information sheet. If diabetes, CGM, or insulin details are part of the child's care, see the diabetes, CGM, and insulin emergency information sheet. If communication or sensory support is part of the child's plan, see the autism, nonspeaking, and sensory emergency information sheet.
Keep a copy somewhere trusted helpers know to check, such as a caregiver binder, emergency bag, medical supply bag, school packet, daycare packet, travel bag, go-bag, medication folder, or with a trusted family member. A copy may also be useful for school nurses, home nurses, respite workers, grandparents, therapists, camp staff, coaches, or caregiver handoffs.
Review the sheet whenever parent or guardian contacts, diagnoses or condition summary, baseline status, devices, supplies, feeding plan location, airway notes, seizure plan location, diabetes care-plan location, medications, allergies, specialists, DME contacts, home nursing contacts, hospital preference, school plan, emergency contacts, or caregiver contacts change.
Families may hear many care-team terms. The printable should not explain procedures; it should point trusted helpers to the current plan, parent or guardian, clinician, supply company, school contact, or device paperwork.
A printable sheet is a useful backup, especially for a child whose care details may be too important to rely on memory during an emergency. YourEMR can also help keep this information organized digitally, update it when details change, print a fresh copy, and choose what can be shared through an emergency QR link.
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These outside resources are for general education only. Always follow the child's care plan, school plan, device instructions, medication instructions, and emergency instructions from the child's medical team.
Emergency preparedness information for families of children with special healthcare needs.
Checklist covering medical information, care plans, medications, supplies, backup power, and equipment planning.
Emergency Information Form resources from the American College of Emergency Physicians and American Academy of Pediatrics.
Professional and family-facing emergency preparedness guidance for children with special healthcare needs.
Professional overview of children with medical complexity, care coordination, medical home needs, technology use, and family burden.
Research article about emergency information forms for children with medical complexity.
Family-focused emergency and disaster planning handout for families of children with special health care needs.
Emergency preparedness information for people with disabilities, access needs, functional needs, caregivers, and support networks.
American Academy of Pediatrics family readiness resource for emergency and disaster planning.
National pediatric emergency care resource center with information for improving emergency care for children.
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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.