This Hospital Readiness Form was created as a useful tool to enable individuals to have all of their medical information in one central location. This form can be shared with a family member and/or your emergency contact. In the event that a hospitalization is required, this form can be taken with you to assist in the continuity of your care during the stay. It can even be used for routine office visits.

The video above explains how to fill out the form step-by-step. Below you can download the form and the NY State Health Proxy form.