Identification Program

As a community service, Baltimore Life offers several ID card programs to local groups and organizations. These programs enhance the safety of the communities we serve.

SportSmart^® ID Card

If you are a cyclist, runner, hunter, or if you enjoy any activities in the great outdoors, Baltimore Life’s SportSmart^® ID card is essential. It includes key medical and contact information that can save your life in the event of an emergency. If you are unable to speak for yourself, your SportSmart^® ID will be able to speak for you.

ID Card Request Form

You must be 18 years or older to request ID cards. You may submit this form up to six times.

First Name:	Required
Last Name:	Required
Address:	Required
City:	Required
State:	--- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Required
Zip Code:	Required
Day Phone:	Required
Email Address:	Required Invalid
Birthdate:	Required
Height:	Required
Weight:	Required
Gender:	--- Male Female Required
Blood Type:	--- O+ O- A+ A- B+ B- AB+ AB- Required

	Emergency Contact #1
Name:	Required
Phone Number:	Required

	Emergency Contact #2
Name:
Phone Number:

	Doctor's Name
Name:	Required
Phone Number:	Required

Medical Conditions

Diabetes Heart Condition Vision Impaired Asthma Glasses Hearing Impaired Contacts Implants Other:

Current Medications

Allergies

Penicillin Codeine Sulfa Insect Stings Demerol List Food Allergies: Any Other Allergies or Additional Details:

	By submitting this information to The Baltimore Life Companies, you are giving us permission to contact you regarding our products and services. Baltimore Life does not share your personal information with any third party without your permission to do so. Please note that any request for a card can only be made for one’s self or for an individual that is in the requestor’s immediate family and a member of the requestor’s household.
	* The SportSmart® card is not a form of legal identification nor is it an insurance policy. The card does not provide insurance coverage. Baltimore Life does not conduct verification of personal identity nor are we responsible for any completion errors. Baltimore Life bears no responsibility if the card is lost or stolen.
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