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Why Emergency Rescue Forms?

Rescue Data form as a WORD Doc

Rescue Data form in PDF Format

In the event that you ever need to have Fire Rescue or an EMS service respond to your home, there is specific information that they are going to request from you. This information is important to them and to emergency room personnel should you have to be transported for emergency care. This form could have the potential of preventing you, a loved one or a friend from being treated with medicine that could accidentally cause harm.

Watching someone you care for experiencing life threatening trauma can be extremely stressful and it might be difficult for you to think clearly in such an emergency situation. If you are the victim and live alone, you may be in severe pain, agitated, or you may have slipped into unconsciousness.  Now is the time to create a document that will deliver needed information for the responding emergency personnel. This page has links to a document titled CERT Rescue.doc or CERT Rescue.pdf. The information requested is the information needed by rescue, EMS and emergency rooms to help provide you with the proper treatment for your condition and expediting that treatment.

To fill the document out, double click on .doc the attachment which will open the document with Microsoft Word, type in your first name and depress the tab key on your keyboard. Each time you depress the tab key you will be moved to the next field. Enter the correct data in each field and tab past the field if no data is necessary. When you have entered data in the last field print the document.  Finally,  save it locally, on your computer for use when updates are needed.

You could also download and printout the .PDF form and fill it out manually.

The document should then be placed somewhere within easy access. This could be a drawer in your kitchen or bedroom, on your refrigerator, or in your Vial of Life container in your refrigerator door. Additional copies of the filled out form should also be placed in your vehicle and in your carry on luggage when you travel.

Please forward this information to your friends even if they do not live in your community.  The information requested is generic to most emergency situations and will certainly be useful for the responding professionals. I can not emphasize enough the importance of keeping all copies of your Emergency Data Form up to date.

            Thank you,

David Bussone


            CERT of the Villages