Enter Medical Information Here for the BACK SIDE of Bracelet:
Text engraved in ALL CAPITAL LETTERS All text centered on back side of pendant
Text entered is limited by the amount of available space on pendant Note: Number in parentheses( ) indicates MAXIMUM # of letters & spaces per line
Back Side Line 1: (20) Back Side Line 2: (20) Back Side Line 3: (20) Back Side Line 4: (20) Back Side Line 5: (20)
Recommendation: Include "SEE WALLET CARD" on the last line above. Keep a medical wallet card with current meds, medical conditions and emergency contacts in your wallet or purse. Keep right behind your driver's license in your wallet.
Our engraving dept. reviews the above information submitted for oblivious misspellings regarding common medical conditions,etc., and will do our best to correct the spelling. However, it is the responsibility of the customer to review the order for accuracy BEFORE placing the order.
Buy Two (2)or more custom ID's and receive a discount!
A few seconds may be required to add this order to the shopping cart. Emerge Alert products are supplied by Apothecary Products, Inc.
Made by an outside supplier
or
Your credit/debit card account number is never given to MedIds.com when order is submitted on-line. See our Privacy Policy here
Our guarantee: This product will be engraved as submitted to us, within the available space limitations, or we, MedIDs.com, will correct the error at no cost. All custom engraved products however are non-refundable as stated in our Return Policy above.
Emerg Alert® is a registered trademark of Apothecary Products, Inc.
Id On Me ® is a registered trademark of ID Ware, Inc.
MEDIDS.COM ®
is NOT affiliated with the MEDIC ALERT FOUNDATION ®
"Medic Alert" is a registered trademark of the MEDIC ALERT FOUNDATION ®
Complete the form below for fax and mail orders
The Print this complete page.
Please review the above order on next page and when you receive your Order Confirmation E-Mail for accuracy. All custom engraved products are non-refundable as stated in our return policy. To expedite the order, we accept U.S. Money Orders Only!
Mail To: First Name:
Last Name:
Address:
City:
State:
Zip Code:
Telephone Number:
If the Print Button does not work on your computer, click on "FILE" - and choose "PRINT" on your browser.
Mail a copy of this completed form with U.S. Money Order payable to "MedIDs.com" to:
MedIDs.com
2400 Cypress St., Su 50 - PMB 211
West Monroe, Louisiana 71291-4563
Or FAX a copy of above order along with the following Credit / Debit Card information to:
(866) 908-8843
( ) Visa ( ) Mastercard ( ) Discover Card ( ) American Express
Name on card: ___________________________________________
Account Number : ________________________________________
Exp. Date of card :______________
Your mailing address where you receive your monthly card billing statement, if different from the above mailing address. _____________________________________________
_____________________________________________
PLEASE ALLOW TWO WEEKS FOR DELIVERY AFTER RECEIPT OF ORDER
Emerg Alert ® is a registered trademark of Apothecary Products, Inc.
Id On Me ® is a registered trademark of ID Ware, Inc.
Road ID® is a registered trademark of Road ID Inc.
MEDIDS.COM ® is NOT affiliated with the Medic Alert Foundation ®
"Medic Alert" is a registered trademark of the MEDIC ALERT FOUNDATION ®
Please Complete this form for On-line, Fax and Mail orders.
What are the spellings for some of the common medical conditions / medications?
Please use this order form for on line Cedit Card orders