Vial of Life

The Vial of L.I.F.E. is a program that is supported by Miami County EMS and local pharmacies to provide vital patient and medical information during an emergency.

Types of Forms

The program consists of a vial that contains a full-size medical form, a wallet-size form, and a label. The medical form is to be completed by you and once completed, placed back in the vial or plastic bag and placed in your refrigerator. The wallet-size form is the same form in a smaller format that can be carried in your wallet / purse.


Once the full-size form is complete and in the plastic bag, the bag is then placed on the top shelf in the door of your refrigerator. The label included is designed to be displayed prominently on your front door. This label will notify responding emergency personnel that additional information will be available.

Where to Obtain

The Vial of L.I.F.E. may be obtained from our office located at 32765 Clover Drive, Paola, Kansas. You can print extra copies of the form or wallet card form the link below. If you need a large quantity, please contact Miami County EMS at 913-294-5010 for additional information. 
    Vial of Life form
    My Medical wallet card