The following is a checklist prepared by advocate Ruth D. Bernstein to help adults with hearing loss (and those with typical hearing) prepare for any medical emergency that might arise. The list, which includes "Circle of Friends," should be shared in advance with the people who will act on your behalf as caregiver.
Personal Identification
- Your full legal name
- Today’s Date
- Update
- Date of Birth
- Social Security #
- Driver’s License # with state issued and expiration date
- Passport # and expiration date
Legal Information
- Names, addresses and phone numbers of people to call in case of an emergency
- Name, address and phone # of your accountant
- Name, address and phone # of your lawyer
- Location of original and copies of your Will, Power of Attorney, Living Will and Health Care Proxy
- Location of current files including income tax returns, deeds etc.
Financial Information
- Bank(s): Name, address, phone number and account numbers of checking, savings, money market accounts
- Bank Card # and PIN (You may not want to give this to anyone but the people who have your power of attorney and/or will execute your will)
- Safe Deposit Box - Location, who has access
- Inventory of contents of the box
- Investment Accounts: Name, Address, phone number of broker and account numbers
- Insurance Policies: Name address, phone number and account number for Home Owners, Health Insurance, Life and Liability
- Retirement Benefits including any insurance policies
- Credit Cards: Company names and 800 numbers, account numbers and PINs
Medical Information
- Doctors: Include name, address and phone numbers of your GP, dentist, eye doctor, hearing health care professional and any other specialist you see
Household Inventory
- Where you keep cash, your drivers license, credit cards and bank cards
- Where you keep jewelry and items of value (include a written and photo inventory)
Funeral Arrangements
- Cemetery: Name, address and phone number of the place you want to be buried
- Instructions for your funeral
Circle of Friends
- A list of people you would want notiufied in the event you have a medical emergency
- Be sure to include names, addresses, phone numbers and email addresses
Please add any other information you think is important.
