RX ON THE RUN

Are you prepared if a disaster strikes? Many people stock up on water, bread, and canned goods, but forget about their medicine and prescription drugs. Rx Response has developed Rx on the Run (formerly called the Rx Response Medication Card), an online tool that enables you to print a personalized medication wallet card that documents your prescriptions, dosages, and other important medical information.

The Rx on the Run card can prove invaluable if a severe public health emergency causes you to lose access to your medicine or prescription information or requires you to refill prescriptions at a pharmacy that doesn’t have a record of your current medications.

Once you fill out the fields below, hit “Create Card” and your personalized Rx on the Run card will be ready for you to print. In addition to keeping a copy in your wallet, you should store a hard copy in a safe place and should also consider sharing a copy with a trusted friend or relative outside your geographic area.

NOTE: The information provided when filling out the Rx on the Run card is not stored or retained by this online tool.

Personal InformationFull Name:

Phone:

Address Line One:

Height:

Weight:

Address Line Two:

Age:

Blood Type:

O+ A+ B+ AB+
O- A- B- AB-

Sex:

Male

Female

Doctor ContactsPrimary CareName:

Phone:

SpecialistsName:

Phone:

HospitalName:

Phone:

Pharmacist/PharmacyName:

Phone:

Emergency ContactName:

Phone:

Current Medications    (Include over-the-counter meds)

Name: Dosage: Frequency:
1.  1.  1. 
2.  2.  2. 
3.  3.  3. 
4.  4.  4. 
5.  5.  5. 
6.  6.  6. 

Allergies

Medical Conditions