Hospital Go Bag Checklist
Use this checklist to make sure you have everything you need for a hospital stay. Check off each item as you pack.
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any allergies?
*
Yes
No
Please list your allergies (if any)
Medications you need to bring
Checklist: Essentials to Pack
*
Photo ID (e.g., driver's license)
Health insurance card
List of current medications
Toiletries (toothbrush, toothpaste, comb, etc.)
Comfortable clothing
Phone and charger
Snacks and water bottle
Book or entertainment
Other (please specify below)
Additional items to bring (optional)
Any special instructions or notes?
Submit Checklist
Should be Empty: