Information that is needed in an emergency,
such as whether you have a
pacemaker or a
stent or have hearing or vision
A list of your long-term (chronic) health problems, such
high blood pressure.
A list of the medicines(What is a PDF document?) you are taking. Include prescription and
over-the-counter medicines, dietary and herbal
supplements, and vitamins and minerals. For each medicine, give the name of the
doctor who prescribed it, why you are taking it, how much you take, and any
A list of your allergies, including
Your medical history
Keep records of:
Major health problems you've had in the past, such as pneumonia or broken bones, or problems with alcohol or drugs.
A history of childbirth, if you're a woman. This includes how many children you've had and any miscarriages, cesarean sections, or abortions you've had.
and adulthood immunizations.
Any health screening results, such as those for
cholesterol, vision, and hearing.
Keep records of major health problems in your family, such as heart disease, stroke, cancer, or diabetes. To keep track of your family health history, use this form(What is a PDF document?) or go to the Surgeon General's family health portrait website at www.hhs.gov/familyhistory.