I made a mistake and turned an ambulance away. The templates that fix it (for you to download).

I was lucky.

I made a bad call, and we were not ready for it.

My wife called an ambulance. I turned it away.

What I missed was the one detail that should have overridden everything: my tongue hung out to the side, and that had never happened before. It was not part of my usual PSP. It was new, and new is exactly the thing that should trigger a call.

But we had never agreed what to do.

So instead of acting on the one sign that mattered, my wife, my live-in carer and I made it up on the doorstep, in front of a crew who knew very little about PSP and had no reason to know that my fixed stare and difficult communication were the disease and not a stroke.

Looking back, it almost feels absurd.

Thank G-d we didn’t suffer for the decision and seemingly got away with it.

Afterwards I realised what we were missing.

Two things.

A procedure that my family, my carer and I are aligned on, agreed in advance rather than invented in a crisis.

And a single sheet for the ambulance crew that explains my situation in seconds, which we now keep up to date.

I looked online for both. I found plenty of emergency medical forms, but nothing that combined a practical escalation plan with a concise ambulance handover sheet for someone living with PSP. Nothing I found really met our needs, so I built them with Claude and agreed the final versions with my neurologist. That last step matters, and I’ll come back to it.

I’ve made generic copies of both, stripped of anything personal, for anyone who wants a starting point.

An escalation plan and a one-page ambulance handover sheet.

They’re written around PSP but can easily be adapted to other conditions.

(My own ambulance handover sheet is, for obvious reasons, written in Hebrew. The version below is a generic English version.)

Three things to be clear about.

If your country or your health service has an approved version of its own, use that instead. A local template will fit your system better than mine, and something officially recognised carries more weight with a crew than a document you made yourself. And if you find a better generic version than these, send it to me, because I’d rather point people to the best resource than insist on my own.

I claim no copyright.

Take them.

Change them.

Share them.

And this is the important one.

These are a structure for a conversation, not a finished document and not advice.

I agreed mine with my neurologist before I relied on it, and the legal parts need a solicitor or attorney because the law differs everywhere. I’ve worked through mine. Please do the same.

A plan you haven’t checked with your own doctor is worse than no plan, because someone will trust it in the one moment it can’t afford to be wrong.

I wasn’t ready.

These are what I built so that you can be.

Escalation plan template
Word: https://1drv.ms/w/c/c9fd23cd51aa6240/IQCA7YZTYTfVTqnDnrNd_eLCAf_5Hd-HfYIpiclp-PKcTCg
Google Doc: https://docs.google.com/document/d/1wMaZu-_b9UH9hkReJIs_hXmG6Bb3-6TJ3qPm4eT1Jq8/copy

Ambulance one-pager
Word: https://1drv.ms/w/c/c9fd23cd51aa6240/IQBoWOzm7AdjQ4kcuRZngcVeAbXdcQsMdzTybF3BC_Nlo7s
Google Doc: https://docs.google.com/document/d/1coFyupCu6vXmmcG9EADNV3yi9pL1Hkjww-dL09xf_04/copy