My ICE Plan Template: Ready-to-Use Format for Family and First RespondersAn ICE (In Case of Emergency) plan is a concise, well-organized summary of the information first responders and loved ones need when you’re unable to communicate. A clear ICE plan can speed up emergency care, reduce confusion, and make sure that medical decisions reflect your preferences. This article provides a ready-to-use ICE plan template, explains what to include and why, and offers practical tips for storing, sharing, and updating your plan.
Why an ICE plan matters
An ICE plan serves three core purposes:
- Faster, more accurate care. First responders can access critical health details immediately.
- Family coordination. Relatives and close friends know whom to contact and what steps to take.
- Peace of mind. You and your loved ones have a clear, documented plan for emergencies.
How to use this template
Use the template below as a starting point. Fill it out clearly, keep it current, and make sure it’s accessible to both family members and emergency personnel. Print a physical copy to carry in your wallet and store a digital copy on your phone and in secure cloud storage.
ICE Plan Template (Ready-to-Use)
Personal information
- Full name:
- Date of birth:
- Address:
- Primary phone:
- Secondary phone:
- Email:
- Photo (optional):
Emergency contacts
- ICE Contact 1 — Name:
- Relationship:
- Phone (mobile/home):
- Secondary phone:
- Email:
- ICE Contact 2 — Name:
- Relationship:
- Phone:
- Secondary phone:
- Email:
- Primary physician — Name:
- Clinic/hospital:
- Phone:
- Address:
Medical details
- Primary medical conditions (all chronic conditions listed):
- Allergies (medications, foods, latex, etc. — include reactions):
- Current medications (name — dose — frequency):
- Past surgeries and dates:
- Important implants or devices (e.g., pacemaker — serial number if available):
- Blood type:
- Advanced directives (e.g., DNR, MOLST — location of copies):
- Organ donor status:
- Recent hospitalizations (reason — date):
Care needs & mobility
- Mobility aids (e.g., cane, walker, wheelchair):
- Home care needs (e.g., oxygen, feeding tube):
- Communication needs (e.g., hearing impairment — preferred language):
- Cognitive considerations (e.g., dementia — level of assistance required):
Insurance & legal
- Health insurance provider:
- Policy number:
- Phone:
- Prescriptions insurance (if different):
- Emergency contact for financial/legal matters:
- Power of attorney — Name and contact (if applicable):
Immediate instructions for responders
- Preferred hospital:
- Allergies or contraindications (bold and short): Allergic to penicillin — severe anaphylaxis
- Medications that must NOT be administered:
- Preferred language for communication:
- Any religious or cultural considerations affecting care:
Location & access
- Home address and any access instructions (gate codes, neighbor with key):
- Vehicle info (make/model/year, license plate, location of key):
- Workplace emergency contact and address:
Digital & other info
- Where to find an electronic health record (portal link and login location):
- Location of advance directive and will:
- Location of spare house/car keys:
- Where to find medical devices and instructions:
Notes & last review
- Additional notes:
- Last updated (date):
- Person who reviewed/confirmed details (name & contact):
Tips for making your ICE plan effective
- Use bold, short facts to highlight life-saving items like severe allergies or DNR orders.
- Keep the document concise — one or two pages is ideal.
- Update it after any significant medical change (new diagnosis, medication change, surgery).
- Carry a physical card or printed sheet in your wallet; keep a copy on your smartphone’s home screen or in a medical app.
- Consider adding an “ICE” contact in your phone’s contact list with the label ICE1, ICE2 so responders and bystanders can find them quickly.
- Share the plan with at least two trusted contacts and your primary care physician.
Ways to share securely
- Printed copy in your wallet and a laminated copy near your primary residence’s entrance.
- Encrypted cloud storage (e.g., password-protected PDF) with access shared to specific family members.
- Upload key info to your phone’s medical ID feature (iPhone/Android).
- Turn off automatic syncing if you want to limit wider access; share directly with named people via secure messaging.
Example filled ICE plan (short)
Personal information
- Full name: Jane A. Doe
- DOB: 03/12/1975
- Address: 123 Oak St., Springfield
- Phone: (555) 123-4567
Emergency contacts
- ICE Contact 1 — John Doe (spouse): (555) 234-5678
- ICE Contact 2 — Maria Lee (sister): (555) 345-6789
- Primary physician — Dr. Alan Park, Springfield Clinic: (555) 456-7890
Medical details
- Primary conditions: Type 1 diabetes, hypertension
- Allergies: Allergic to penicillin — anaphylaxis
- Medications: Insulin lispro — 5 units as needed; Lisinopril 10 mg daily
- Blood type: O+
Immediate instructions
- Preferred hospital: Springfield General
- Do NOT give: Penicillin or related antibiotics
- Preferred language: English
Last updated: 08/01/2025 — Verified by John Doe (spouse)
Final checklist before you save and share
- Have you listed at least two ICE contacts with phone numbers?
- Are severe allergies and DNR/advance directives clearly emphasized?
- Is the plan no longer than two pages for quick scanning?
- Have you stored both a physical copy and an accessible digital copy?
- Did you tell your ICE contacts where the plan is stored?
Keeping an up-to-date ICE plan is a small effort that can make a big difference during an emergency. Use this template, adapt it to your situation, and review it regularly so your family and first responders always have the information they need.
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