Med-Alert Labels – 14 Titles Available – 2 1/2″ x 2 1/2″
$44.95 – $49.95
Choose From 14 Titles – Select your title from the drop down menu above.
“ADVANCE DIRECTIVES” Orange Fluor.
- ADVANCE DIRECTIVES
___ DURABLE POWER OF ATTORNEY FOR HEALTHCARE
___ LIVING WILL
Med Alert Label in Orange Fluorescent with Bold Black type. ___
“ADVANCE DIRECTIVES” Green Fluor.
- ADVANCE DIRECTIVES
___ DURABLE POWER OF ATTORNEY FOR HEALTHCARE
___ LIVING WIL
___ HEALTHCARE PROXY
Med Alert Label in Green Fluorescent with Bold Black type. ___
“ADVANCE DIRECTIVES” Yellow Fluor. (1)
- ADVANCE DIRECTIVES
___ DO NOT RESUSCITATE
___ DURABLE POWER OF ATTORNEY FOR HEALTHCARE
___ LIVING WILL
___ HEALTHCARE PROXY
Med Alert Label in Yellow Fluorescent with Bold Black type. ___
“ADVANCE DIRECTIVES” Yellow Fluor. (2)
- ADVANCE DIRECTIVES
___ DURABLE POWER OF ATTORNEY FOR HEALTHCARE
___ LIVING WILL
___ HEALTHCARE SURROGATE
Med Alert Label in Yellow Fluorescent with Bold Black type. ___
“SIGNIFICANT CHANGE IN HEALTH STAT” Pink Fluor.
- SIGNIFICANT CHANGE IN HEALTH STATUS
DATE OBSERVED: __/__/__
PHYSICIAN NOTIFIED: __/__/__
FAMILY NOTIFIED: __/__/__
OTHER: _______ __/__/__
RE-ASSESSMENT COMPLETE: __/__/__
NEXT ASSESSMENT DUE __/__/__
Med Alert Label in Pink Fluorescent with Bold Black type. ___
“ALLERGIES” Red Fluor.
- ALLERGIES ____________
Med Alert Label in Red Fluorescent with Bold Black type. ___
“MEMO” Pink Fluor.
- MEMO ____________
Med Alert Label in Pink Fluorescent with Bold Black type. ___
“MEDICARE CHARTING” Green Fluor.
- MEDICAL CHARTING
DATE: _____
DIAGNOSIS: _____
CHARTING TO INCLUDE: _____
Med Alert Label in Green Fluorescent with Bold Black type. ___
“DR. PLEASE SIGN….” Red Fluor.
- DR. PLEASE SIGN ______
DISCHARGE SUMMARY ______
HISTORY & PHYSICAL _____
OPERATIVE REPORT ______
CONSULTATION _____
OTHER _____
Med Alert Label in Red Fluorescent with Bold Black type. ___
“DRG MEMO” Orange Fluor.
- DRG MEMO ____________
Med Alert Label in Orange Fluorescent with Bold Black type. ___
“RAI SCHEDULE” Yellow Fluor.
- RAI SCHEDULE
OBSERVATION END DATE: __/__/__
MDS DUE: __/__/__
RAPS DUE: __/__/__
CARE PLAN DUE: __/__/__
MDS ELECTRONICALLY SUBMITTED: __/__/__
Med Alert Label in Yellow Fluorescent with Bold Black type. ___
“DOCTOR PLEASE NOTE” Pink Fluor.
- DOCTOR PLEASE NOTE DATE ____________
Med Alert Label in Pink Fluorescent with Bold Black type. ___
“VOLUME RECORDS” Yellow Fluor.
- VOLUME RECORDS. THIS RECORD HAS BEEN DIVIDED INTO VOLUMES AS LISTED BELOW. THE CHECK MARK INDICATES THIS VOLUME. IF ADDITIONAL VOLUMES ARE REQUIRED, CONTACT THE MEDICAL RECORDS DEPARTMENT.
DATE
___ VOLUME 1___
___ VOLUME 2___
___ VOLUME 3___
Med Alert Label in Yellow Fluorescent with Bold Black type. ___
“DOCTOR PLEASE NOTE DATE___ ” Pink Fluor.
- DOCTOR PLEASE NOTE DATE ____________
Med Alert Label in Pink Fluorescent with Bold Black type. ___
