Fill out the form below to create your ID. You can print it out and keep it in your wallet or purse. In case of an emergency, first responders will be able to use the information on your ID to contact your emergency contact.
To prevent misunderstandings, please see reverse for symptoms.
Instructions
Printers vary in size and capacity. For best result, make sure you select "actual size" in the print dialog.
View Printing InstructionsPlease select the symptoms that apply to you. You can choose a maximum of 8 symptoms. This information will be printed on the back of your ID card. Remove an item from the list by clicking on it inside "Preview".
If you have any other symptoms that are not listed above, please add them below.