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VIAL FOR LIFE

 

Butler County Emergency Medical Services has reinitiated the Vial for Life program and is making it available to all interested persons within Butler County free of charge.  This program allows for an individual’s vital medical information to be recorded on a standardized form and left in their home or vehicle so that responders can locate the information during emergency situations. All personal information is recorded on a form and kept in your home until emergency responders need to access the information. No personal information will be collected or filed with EMS—this program is completely voluntary and confidential.

 

If you would like someone from EMS to contact you regarding the Vial for Life, or to make arrangements to obtain a Vial for Life, please submit the form below or contact our offices!

 

 

YOUR NAME:
HOME ADDRESS:
HOME CITY:
HOME PHONE:
OTHER PHONE:
WHEN MAY WE CONTACT YOU: Anytime Day Evening
COMMENTS: