ULTIMATE Emergency Information Package

Ultimate Emergency Contact Package!

Includes a unique QR Code sent to you in your email as an attachment file set.

Includes a Secondary QR Code displaying the text “My Emergency Info” above and below the QR Code itself.

UNLIMITED also means that you can order Custom Fields of your liking! Just send an email with your requests!

You will receive a QR Code in an email, as an attachment in PDF and JPG Formats.

Please look at the many other available options for your Emergency Contact QR Code HERE. With the ULTIMATE Emergency Package, you may also email us with additional contacts and additional physician contact information. Your information is NOT available to anybody but you. By submitting the form, you give your consent to let your information be seen in any emergency.

Cost: $120.00
We accept Zelle to alltexasmedia@gmail.com, CashApp, Venmo or Mailed Money Order. Mailed Money Order will result in a delay of receiving your package. Email us for our postal address. Our email is myemergencyinfo911@gmail.com

Today's Date *

Your Name *

Your Email Address *

Your Name As Shown To The Public *

Your Birthday To Be Shown *

My Medical Condition

My Blood Type

Emergency Contact Name *

Relationship To You *

Emergency Contact Phone *

Second Emergency Contact Name

Relationship To You *

Second Emergency Contact Phone