Indiana Statutes
§ 12-9.1-6-6 — Standard medical information form
Indiana § 12-9.1-6-6
JurisdictionIndiana
Art. 9.1DIVISION OF AGING
Ch. 6Yellow Dot Motor Vehicle Medical Information Program
This text of Indiana § 12-9.1-6-6 (Standard medical information form) is published on Counsel Stack Legal Research, covering Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
Bluebook
Ind. Code § 12-9.1-6-6 (2026).
Text
(a)The division of aging shall create a
standard medical information form that allows a program participant
to supply the following information:
(1)The program participant's name.
(2)A photograph of the program participant.
(3)The contact information for not more than two (2) emergency
contacts for the program participant.
(4)The program participant's medical information, including
medical conditions, recent surgeries, allergies, and current
medications.
(5)The program participant's hospital preference.
(6)The contact information for not more than two (2) health care
providers of the program participant.
(7)The date the program participant completed the form.
(b)The standard medical information form must include the
following statements:
(1)A statement that the program acts as a
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Legislative History
As added by P.L.59-2025, SEC.1.
Nearby Sections
15
§ 12-10-1-1
Establishment of bureau§ 12-10-1-2
Purpose§ 12-10-1-3
Administration of programs§ 12-10-1-4
Duties§ 12-10-1-5
Coordination of services with area agencies§ 12-10-1-6
Area agencies; duties; coverage area changes§ 12-10-10-1
"Case management"§ 12-10-10-1.5
"Activities of daily living"§ 12-10-10-10
Services funding; source§ 12-10-10-12
Negotiation of reimbursement rates§ 12-10-10-2
"Community and home care services"Cite This Page — Counsel Stack
Bluebook (online)
Indiana § 12-9.1-6-6, Counsel Stack Legal Research, https://law.counselstack.com/statute/in/12-9.1-6-6.