TAYLOR, EMMA ROSE

Emergency Medical Profile

Emma Rose Taylor

Printed on product as “Emmy”

DOB:3/14/2023

Photo of Patient Photo of Patient
Life-Saving Alerts — Critical No Known Alerts

Emergency Contacts

Primary Emergency Contact

Sarah Taylor

Mother

(574) 297-6307Tap to call
Backup Emergency Contact

Josephine Jones

Grandmother

(555) 888-2132Tap to call
Additional Emergency Contact

James Taylor

Father

(555) 888-2121Tap to call

Patient Demographics

Home Address 4821 Maple Grove Lane
Carmel, IN 46032
Blood Type o+

Clinical & Insurance Details

Primary Care Physician Dr. Karen Mills, Riley Hospital for Children
(317) 555-0210Tap to call
Insurance Provider & Policy # (optional) see card
Insurance Card — Front Insurance Card — Front
Insurance Card — Back Insurance Card — Back

Legal Authorization

I authorize emergency medical personnel and first responders to access the information on this profile for the purpose of providing emergency medical care to the individual named above. This information is accurate to the best of my knowledge as of the date listed below.

Form Completed By Sarah Taylor Mother
Date Completed 7/4/2026

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