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Wallet Card

The document provides instructions for printing, completing, and carrying a wallet card with medical information. The card is meant to be filled out with a person's name, emergency contact information, current medications, medical conditions, and physician contact details. The purpose is to alert emergency responders if the person becomes too weak to communicate due to myasthenia gravis and needs immediate medical help.

Uploaded by

Caralyn Chung
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
39 views

Wallet Card

The document provides instructions for printing, completing, and carrying a wallet card with medical information. The card is meant to be filled out with a person's name, emergency contact information, current medications, medical conditions, and physician contact details. The purpose is to alert emergency responders if the person becomes too weak to communicate due to myasthenia gravis and needs immediate medical help.

Uploaded by

Caralyn Chung
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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MG Wallet Card

1. Print out the page


2. Complete this card by writing in the recommended information - feel free to fill out multiple
copies
3. Cut on the solid line
4. Fold on dashed line
5. Place in your wallet, glove compartment, purse, etc.

_____________________________________________| _____________________________________________
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Current Medications: ___________________________ Other Medical Conditions: _______________________
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Alt. phone: ___________________________________ Alt. phone: ___________________________________
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Phone: ______________________________________
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Phone: ______________________________________
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Relation: _____________________________________
City: _____________________ ST: _____ Zip: _______
| Address: _____________________________________
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Name: ______________________________________
My Name: ____________________________________
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In case of emergency, please contact:

- Medical Alert -
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Physician Information
| I am Ill
My Physician’s Name: | I have a disease called myasthenia gravis that makes me
| so weak I may not be able to stand up or speak clearly. I
_____________________________________________ | am not intoxicated. If I appear to need help, please call
| 911 or my physician immediately. (See other side)
My Physician’s Phone: | Myasthenia Gravis Foundation of Illinois, Inc.
| 800.888.6208
www.myastheniagravis.org
_____________________________________________
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Myasthenia Gravis of Illinois, Inc.


275 N. York Street ● Suite 401 ● Elmhurst, IL 60126
Phone: (800) 888-6208
www.myastheniagravis.org

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