Are you prepared if a disaster strikes in your area? Many people stock up on water, bread, and canned goods, but forget about their medicine and prescription drugs. Rx Response has developed a tool to document and print a personalized medication wallet card that documents your prescriptions and doses, which can then be referenced during a severe public health emergency.

Once you fill out the form's fields, this tool will generate a wallet-size card with vital information—including the medicines you take regularly and any medication allergies you’ll need to watch out for during a public health emergency. You should store a hard copy in a safe place, and perhaps send a copy to a trusted friend or relative outside your geographic area for use as a reference should the need arise.

Rx Response has developed this tool to help you prepare for your medical needs during a public health emergency. When you are finished filling in the form, hit "Create Card" and a formatted information card with all of your information will be prepared.

All the information you provide is treated as private; we will not store any data that you enter through this tool. Create your medication card dynamically, fill out the form below, and your card will be populated and printable in PDF format.