In Case of Emergency – Medical Information Sheet (ICE Form)

Emergency situations can be hazardous, especially seniors and adults with disabilities. As part of our continuing support, we recommend everyone to complete your ICE Form.   Please ensure it’s up to date and keep it somewhere safe in your home.   We have provided a popular version of the form below from Toronto Paramedic Service, but you can also make your own that is clearly labelled ‘ICE’ or ‘In Case of Emergency’.

Note: This form is voluntary – do not send it back to us.

ICE Form To ensure you get the proper care in the event of an emergency, the Toronto Paramedic Services  have developed a sheet called “In Case of Emergency”, or ICE for short.   We encourage everyone to fill out the form and keep it in an easily accessible place (For example:  your fridge, the back of your front door and/or your wallet or purse).

The sheet is easy to read and contains valuable information for paramedics and healthcare providers should you not be able to speak for yourself or remember important information in an emergency.

This form is voluntary and assists healthcare providers take care of you as efficiently as possible in the event of an emergency.  We urge you to include information of one person whom emergency personnel can reach on your behalf, as well as any medical conditions and/or allergies that would be beneficial for emergency personnel to know.

If you have any questions or would like assistance in filling out this form, please call Sarah (416) 653-3535 Ext. 333

Forms can be downloaded by clicking the image above.

The ICE Form is also available in several different languages.   They offer translations in Arabic, Chinese (Traditional/Simplified), Farsi, French, Tagalog, Greek, Hungarian, Tamil, Italian, Korean, Polish, Portuguese, Punjabi, Russian, Spanish and Vietnamese.