Vial of Life
The Vial of Life, sponsored by the Douglas County Health Department, is designed to help emergency response personnel provide the best possible care and quickest response time. This is accomplished by providing important medical information to personnel responding to an emergency. Senior Citizens, people who live alone, anyone with a chronic illness, or medication allergies can benefit from Vial of Life. This includes anyone with diabetes, epilepsy, kidney disease, heart disease, or any other illness where emergency care may be necessary.
The Vial of Life is a container that holds important medical information such as a list of medications, allergies and special needs. The vial may also contain a copy of a living will and contact names and phone numbers. The Vial of Life is kept in the refrigerator in a designated location, where emergency personnel can easily find it. A decal provided in the start-up kit is placed on the front door of your home to alert emergency personnel to retrieve the vial. An additional vial may be placed in your automobile glove compartment for easy access.
The information contained in the Vial of Life helps emergency medical personnel and firefighters when responding to an emergency. It's a simple program that can save your life or someone you love. To receive your Vial of Life start-up kit, call the Health Department at (217) 253-4137.
For your convenience, we have also included downloadable versions of the Medical Data Form and the door alert placard on this webpage. Use the links provided to print the Medical Data Form and door alert placard, please pay careful attention to the following instructions for display:
Instructions for Vial of Life
- Fill out the medical history form completely and accurately.
- Place medical history form in the vial available free from the Health Department.
- Put vial in ziplock bag and place on upper right hand shelf of the refrigerator.
- If you don't yet have your Vial from the Health Department, print an additional door alert placard and place it in the ziplock bag with your medical data in such a way that it is prominently visible through the bag.
- If there is more than one Vial of Life participant in the house be sure and label the ziplock bags with the name of the participating person.
- Place door decal on the outside of the front door, above the door handle at eye level.
Printable Items
- Print the Medical Data Form: Vialdata.pdf
- Print the Door Alert Placard: Vialplacard.pdf
If you require any assistance in completing the documents, would like to request a vial start-up kit, or have any other questions regarding the Vial of Life Program please feel free to call the Douglas County Health Department at (217) 253-4137.