Vial of Life Information

Vial of Life StickerThe Community Living Campaign (CLC) and the California Alliance for Retired Americans (CARA) are working together to help spread the word about a simple way to provide critical information to paramedics and other health professionals in an emergency.  The Vial of Life is a simple form that that lists all your important medical information in a location that medical personnel can find quickly in an emergency.

While there are different types of Vial of Life programs, they all function similarly. When the paramedics arrive at a home, a sticker on the front door (or a front window) alerts them that the resident has completed a Vial of Life form. The sticker also tells the paramedics where the form is kept, typically on the refrigerator.

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The Vial of Life program has been around for some time.  But interest has been growing again as more and more of us want to be more proactive in protecting our health and well-being as we grow older. Originally, Vial of Life kits came with a plastic vial (an empty pill bottle).  Nowadays, most projects ask individuals to  place their completed medical form inside a plastic bag with a Vial of Life sticker on it. This bag is then posted on the  refrigerator.

Download Free Forms

If you’d like to create your own Vial of Life, you can download what you need right here for free. Fill out the Medical Information form (there are instructions as well). Print out the red images onto large label paper or simply print on regular paper, cut, and tape or glue to plastic bag and front door.

English Vial of Life Form:

Download (PDF)

Chinese & English Vial of Life Form (important: please fill in form in English so that emergency responders can read it):

Download (PDF)

Vial of Life Stickers:

Download (PDF)

 

Get Forms and Stickers for Your Organization

CLC and CARA are looking to expand the number of people using the Vial of Life working through existing organizations.   If you would like to order stickers and forms for your organization, please contact us at info@vialoflife-ca.org.