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Have you thought about what the immediate aftermath of a serious crash might be? Would you be conscious? Able to speak? Able to tell first responders what medications you’re taking, any special medical considerations and who to contact?

These considerations and the importance of administering the most effective care as quickly as possible to crash victims led to the creation of the Yellow Dot Program.

It is designed to communicate critical information to first responders when crash victims might not be able to speak for themselves.

This program acts as a facilitator only. All information provided on this PDF form is your sole responsibility. Please update as needed.


Emergency Information System

This medical form is designed to supply first responders with critical information about you during in an emergency, when you might not be able to communicate yourself.

Participation is voluntarily and authorizes the disclosure to, and use of, your medical information by first responders for the purpose of offering assistance when involved in an accident.

For more information, call 801-585-2991, email or visit

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