EMERGENCY MEDICAL
INFORMATION FORM

The City of Peoria has provided an Emergency Medical Information Form to be completed by each occupant of a home. Download, print, and complete this form, and then attach it to the back of your bathroom medicine cabinet. In the event of an Medical Emergency at your home, the City Of Peoria Fire Department will check the back of your medicine cabinets for this information. In the event that you are in your home alone and become incapable of talking to the Paramedics, this information could be invaluable at providing life saving information.

To open and print the form you must have the Adobe Reader installed on you PC. Download the Adobe Reader for free by clicking on the following Adobe Reader Icon.

To get the Emergency Medical Information Form CLICK HERE.