Here is a helpful list of basic health-related questions we believe one should carry at all times in the event of something happening. For example, if you or a loved one is rendered incapacitated, someone can refer to this list for immediate action. Please print a copy or save a digital version for yourself or to share with your loved ones.
For more forms and in-depth questions, you can purchase a download of My Living Legacy here.
Name (first, middle, last)
See medical directive in wallet (if it applies)
Family / Friend names, addresses, contact numbers, and email addresses in case of emergency:
Anatomical Gift Statement: Upon my death I wish to donate All organs, tissues, or eyes
(Check here)_______ – OR – I refuse to make an anatomical gift (Check here)_______
Resuscitate if possible (Check here)_____ – OR – Do not resuscitate (Check here)_____
(This represents my electronic signature)