10.07.2015 Views

Accu-Chek Spirit Combo insulin pump—Quick Reference Guide

Accu-Chek Spirit Combo insulin pump—Quick Reference Guide

Accu-Chek Spirit Combo insulin pump—Quick Reference Guide

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I am a diabetic patient being treated with an <strong>insulin</strong> pump, that delivers<strong>insulin</strong> via a tube into my skin. If I show abnormal behavior or I am unconscious,please pull the tube with the needle out of my skin or cut the tubeoff directly at the needle. If I am able to swallow, give me sugar in someform immediately. Notify a doctor, hospital or ambulance.


Emergency CardNameAddressPhoneIn case of emergency please contact:NamePhone


Medical CertificateThis is to certify thatMrs/Mr05331803001/CDate of birthhas DIABETES MELLITUS.She/He has to rely on regular supply of <strong>insulin</strong> with the <strong>Accu</strong>-<strong>Chek</strong> <strong>Spirit</strong> <strong>Combo</strong><strong>insulin</strong> pump Serial No.which he/she carries with him/her.


Place and dateName of doctorPhoneFaxSignatureStamp

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