Heart Attack Survival Plan

Page Updated: 2-8-2007

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Heart Attack Survival Plan

Fill in the information below. Keep this form in a handy place. You may want to photocopy it and keep a copy at home, work, and in your wallet or purse. Share the information with emergency medical personnel and hospital staff.

Your name:

Medicines you are taking:

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10.

Medicines you are allergic to:

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If symptoms stop completely in less than 5 minutes, you should still call your health care provider.

Phone number during office hours:

Phone number after office hours:

Person to contact if you go to the hospital.

Name:

Home phone number:

Work phone number:

[Back To Heart Attack Symptoms]

The health information on this site is for education purposes only. HeartSpring.net assumes no responsibility in treatment or cure of any disease or illness. The information provided on Heartspring.net is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician.

Your suggestions are welcome - email Gwendolyne & Mark Kelly
810 Dorchester Road, Baltimore, MD 21229

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