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Emergency Information Forms

The Black Forest, Falcon, and Donald Wescott fire districts have combined forces to create a medical information sheet that will help us treat you or your family members if we respond to your home on a medical call. 

Please download and complete a copy of this form for every person in your household. Once complete, be sure to leave these forms in an easily located place. We recommend sticking them on your refrigerator, so they are easy for us to find if you are unable to help us.

Emergency Information Form (in Microsoft Word format)

Emergency Information Form (in Adobe Acrobat format)

Click here to download the free Acrobat reader

Of course, you may always visit Fire Station One to pick up a form if you are unable to download or print one.

Carry emergency information when you're away from home

If you have a medical emergency away from home, there are two simple ways to help an ambulance crew find your important medical information.

Carry medical info in your wallet or purse

You can carry a copy of our Emergency Information Form, or write the same information on a small card.

Record an "ICE" number on your cell phone

Record the number of a trusted person who knows your medical details. But instead of recording that person's name in your phone book list, use "IN CASE OF EMERGENCY" or "ICE."