“I Have A Health Care Proxy” Wallet Card
In an emergency, your wallet card helps medical providers quickly contact Health Care Agent.
Make your own card. It's easy to do!
Once you have completed a MA Health Care Proxy, the legal document that appoints your Health Care Agent, you can make your own wallet card. The wallet card tells emergency personnel to call your Health Care Agent in case of a medical emergency.
IMPORTANT: The wallet card is for informational purposes only; it is NOT a legal document. It does not replace your Health Care Proxy. To use this card adults must have completed a Health Care Proxy which gives your Health Care Agent the legal authority to make decisions on your behalf.
Want to complete a Health Care Proxy document? Click here.
How to Make a Wallet Card
The Wallet Card is available in English and 6 other languages. To make your own card-
- First, choose a language in the next section below.
- Download and print your wallet card on a regular sheet of paper (pictured here).
- Follow the instructions to cut out and fold the card.
- Fill out the card and store in your wallet.
Choose a Language. Download and Print Your Wallet Card
Instructions:
- Download and print on regular paper in color or black & white.
- First, cut out the card along the bold outline. It's the long rectangle shape.
- Fold along the dotted lines.
- Fill out the card. Store in your wallet with your ID.
The I Have A Health Care Proxy cover flap lifts up to reveal the contact information and closes to keep it protected. You can also write any information you like in the blank areas.
IMPORTANT: Adults must have a valid Health Care Proxy to use this wallet card. Your Health Care Proxy is your legal document that gives your Health Care Agent the authority to make health care decisions on your behalf. This informational wallet card is NOT a legal document. It does not replace your Health Care Proxy.