Contact person In Case of Emergency (ICE)
Phone number for ICE contact
GP Details
Specialist Details
Hospital Details

The above information is required to complete the standard Medi-Alert Card. Currently the card is wallet size (business card), but you can trim it to a smaller size.

Remember - This card is to help you feel safer so don't hesitate to ask and we will try to make it your card.

The card is no burden to carry and we hope that you will never need to use it, but it could come in handy should the need arise.

The card is produced FREE of charge and will be forwarded with the next issue of 'MessaGes', unless you would like it earlier.

Note: Medi-Alert Cards are only available to members of the Association.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Enter the characters shown in the image.