Medical Information Form

The Fountain Hills Fire Department and its volunteer support group “C.A.R.E./FH” have created a “C.A.R.E. Package” that will provide important personal medical information to Fire Department and Ambulance Paramedics during an emergency. The package is a labeled prescription vial that includes a medical information form along with a refrigerator magnet and 1” sticker. The blue “C.A.R.E./FH” heart logo is featured on the magnet and sticker alerting first responders to your participation in the program. It is requested the magnet be placed on the outside, upper corner of your refrigerator door. Options for the 1” sticker location include on the vial cap or at the front door. The vial with the completed form is placed in a visible location inside the refrigerator door.

Thanks to a generous donation from the Langston Family Foundation and support from the local Basha’s and Safeway pharmacies, a limited supply of complete “C.A.R.E. Packages” are available. Complimentary “C.A.R.E. Packages” can be picked up at both Fountain Hills Fire Stations, Basha’s and Safeway Pharmacies, as well as additional locations as the program expands.

It is important to keep the medical information current. Additional forms can be filled out and printed from the link below or from the C.A.R.E. website. Contributions to the “C.A.R.E./FH” program (501c3) are graciously accepted at the C.A.R.E. website to help keep this 100% volunteer/donation-funded program operational. Fountain Hills Fire Department and “C.A.R.E./FH” thank you for your support.

Click here to download the Medicial Information Form.

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