Practical Hints to Living in Spain - Advice on moving to Spain to live Bilingual SOS Form
Help yourself by printing out and completing this form.
Always keep a copy with you.
If ever you are ill or in an accident it will be of great benefit
both to you and the hospital
Practical Hints to Living in Spain - Advice on relocating to Spain
English Information about myself / Informaciones Sobre El Enfermo Espagñol

Surname

Apellido

Forenames

Nombres

Resident/Tourist

Residente o turista

Nationality

Nacionalidad

Home Address



Domicilio habitual

Address in Spain
(if different)



Direccion en España

Telephone

Telefono

Date of Birth

Fecha de nacimiento

Name, address & telephone number of person to be contacted if admitted to hospital




Nombre, direccion y n de telefono de la persona a advertir en caso de ser in resado en el hospital

Spanish Social Security Number

Numero de Seguridad Social Española

NIE (Residencia) No

Numero de NIE/DNI

Passport Number

Numero de pasaporte

Medical insurance company, policy number & telephone number



Seguro medico, numero de poliza y numero de telefono

I have form E111/E121

Tengo E111/E121

Long term illnesses and year first suffered

Enfermedades cronicas y ano de comienzo

Operations and year performed

Operaciones y anos de las mismas

Present medication



Medicamento actual

Allergies to any drugs

Medicamentos no tolerados

Blood Group

Grupo sanguineo

We suggest you make copies of this page and keep it in your car, wallet or handbag
Copyright Maurice Hamlin 2002-2004