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John Anastasio's
Emergency Responder Card

 
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Click here     to print this window. After the page finishes printing, please cut out the emergency responder instruction card along the border, sign and laminate it, fold it lengthwise, and keep it with you in your purse or wallet.

Emergency Responder Instructions

If I am in need of emergency medical assistance, I,  John Anastasio, or my legal guardian authorize any competent first responder to access and use my vital healthcare information to provide me with reasonable assistance. Please enter this URL in any Web browser:


https://www.thesmartphr.com/toolboxlive/
To access my account please use the following:

User ID: JohnAnastasio
Password: U3XGF12C
Name: John Anastasio

Emergency contact name and phone number(s): Marjorie Anastasio, 303-449-3151

Blood Type: O-
Allergies: COMPAZINE-severe lockjaw reaction, Penicillin
Immunizations: POLIO, CHICKENPOX, MMR, TETANUS-DIPTHERIA
Medications: Ritalin, Albuterol Aerosol
Health History: ADD CHLD WITHOUT MENTION HYPERACTV, UNSPECIFIED ASTHMA, CLOSED SUPRACONDYLAR FRACTURE FEMUR

Signed________________________Dated_________
Copyright 2005 Prosocial Applications, Inc. www.thesmartphr.com