Free Printable Stroke and Aphasia Emergency Information Sheet
A free printable emergency information sheet for organizing baseline communication needs, aphasia support notes, mobility or weakness baseline, medications, allergies, therapists, doctors, caregivers, and emergency contacts.
This may be called a stroke emergency information sheet, aphasia communication handoff sheet, post-stroke face sheet, or caregiver communication notes page.
No signup is required to download the printable PDF.
The main emergency information sheet download stays separate.
Stroke / Aphasia emergency information sheet preview
Who it helps
Stroke survivors, people living with aphasia, people with speech or language changes, older adults, family caregivers, communication partners, home health aides, therapists, travel companions, and trusted helpers.
Why this can matter in an emergency
A person with aphasia, speech changes, language-processing changes, weakness, hearing or vision needs, or mobility changes may not be able to explain their baseline easily in a stressful moment.
A concise sheet may help caregivers, urgent care, ER teams, EMS, therapists, or family members understand caregiver-provided baseline context and find the right contacts.
Stroke and aphasia handoff notes
These notes can describe what is usual for the person and how they prefer to communicate. Do not use it to judge new symptoms or replace professional guidance.
What communication method works best on a typical day
Whether the person understands more than they can say, needs extra time, uses gestures, or benefits from written choices
Whether a communication card, AAC device, notebook, phone app, hearing aids, glasses, or caregiver support is usually needed
What mobility, weakness, fatigue, swallowing, or caregiver support notes are part of the person's baseline if the family chooses to include them
Who can confirm current baseline and where fuller therapy or care-plan notes are kept
Where to keep it
Keep copies with communication cards, in a caregiver binder, wallet or purse, therapy bag, refrigerator folder, go-bag, travel folder, or with a trusted family member.
Tell trusted caregivers and family where the current sheet and fuller communication or therapy notes are kept.
When to update it
Review the sheet when communication needs, preferred methods, mobility baseline, assistive devices, medications, allergies, doctors, therapists, pharmacy, caregiver contacts, emergency contacts, or care-plan documents change.
It may also be worth reviewing after a hospital discharge, rehab stay, therapy update, new communication tool, travel plan, or new caregiver handoff.
Privacy and safety notes
Share only what is useful for emergency organization and communication support. Avoid 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, stroke emergency guidance, speech therapy plans, rehabilitation plans, medical records, medication labels, care plans, discharge instructions, or patient portals. Do not use it to evaluate new symptoms, delay emergency care, or provide rehabilitation instructions.
Printable sheet versus digital emergency profile
A digital YourEMR profile may help when communication notes, medication lists, allergy lists, doctors, therapists, mobility notes, or caregiver contacts change. It can be updated, printed again, or shared through an emergency QR link.
Helpful terms families may hear
Aphasia: A language-processing difficulty that can affect speaking, understanding, reading, or writing.
Baseline communication: How the person usually communicates on a typical day.
Communication partner: A trusted person who helps the person communicate or confirm context.
AAC: Augmentative and alternative communication tools, such as cards, devices, apps, or other supports.
Mobility baseline: How the person usually walks, transfers, or moves with support.
Caregiver handoff: Short notes that help another trusted person understand baseline communication, contacts, and document locations.
Stroke / Aphasia details to record
Keep the sheet factual and focused on current baseline, contact details, and where fuller care or therapy notes are kept.
Baseline communication needs, including aphasia, speech, language, reading, writing, hearing, vision, preferred language, or communication partner support
Preferred communication methods, such as yes/no questions, written keywords, picture cards, device or app name, gestures, extra time, or trusted caregiver interpretation if applicable
Mobility or weakness baseline, assistive devices, fall-risk context, and accessibility needs without giving transfer or therapy instructions
Medications, allergies, doctors, therapists, pharmacy, emergency contacts, caregiver contacts, and decision-maker contact if applicable
Where therapy notes, discharge summaries, communication cards, medication lists, and care-plan documents are kept
Related YourEMR resources
Use these related YourEMR pages when they fit the person's situation.
Helpful stroke, aphasia, and communication resources
These outside resources are for general education only. Always follow the person's clinicians, therapists, care plan, medication labels, discharge instructions, and emergency guidance.
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.
