Vial Of Life Medical Information Form - Valley Park Fire District

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Vial of Life
Sponsored by
The Valley Park Fire Protection District
Vial of Life
The
puts important medical information in the hands of Emergency Medical workers when it is
needed most…..during the first minutes of a critical illness or injury.
1. Fill out the
Vial of Life
medical information form.
Fill out the included form. (see below)
Please answer all pertinent questions.
Vial of Life
2. Place completed form in the
sealing bag
and place in the top shelf of your refrigerator door.
You may also consider placing the following items in the bag as well:
Living will and durable power of attorney forms
DNR (Do Not Resuscitate) forms
Copy of last EKG
3. Place the provided
Vial of Life
magnet or sticker on the
upper corner of your refrigerator AND on the main door
of your residence.
Make it readily visible so emergency personnel know that you
participate in the Vial of Life program.
4. Make additional copies of your
Vial of Life
to carry with
you or in your vehicle.
You can obtain extra stickers, magnets, and forms by contacting
us.
5. Make it a habit to review and update your
Vial of
Life
when you change your clocks.
Contact the Valley Park Fire Protection District with any
questions or for additional supplies at (636) 225-4288.
Or visit us on the web at:
Update your Vial of Life

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