Medical ID Bracelet Request Form

Bracelets from Sticky J are currently only available to individuals in the following countries: United States, Australia, Canada, New Zealand, Austria, Barbados, Denmark, Finland, France, Germany, Ireland, Israel, Italy, Jamaica, Japan, Mexico, Netherlands, Norway, Puerto Rico, South Africa, Sweden, Switzerland, and the United Kingdom. Currently we can only accept orders to these countries.
Submitter Information



Please double check your email for accuracy so we can contact you about your order.












Bracelet Styles
Style 1: Stainless Steel Medical ID Bracelet
(See full details from Sticky J)
Stainless Steel Medical ID Bracelet



Style 2: Sport Strap Medical Alert Bracelet for Kids/Adults

(See full details from Sticky J)
sport strap medical alert bracelet for kids or adults in multiple colors



Style 3: Adjustable Black Polyester Medical ID Bracelet 

(See full details from Sticky J
Adjustable Black Polyester Medical ID Bracelet
Bracelet Style




Sample Bracelet Language
Example Bracelet:

Jane Smith

VEDS: Artery & AoD

Organ rupture,

PTX/HTX, CCSF

ICE: 123-456-7890

No: Penicillin

Prefilled fields (Cannot be changed):

VEDS: Artery & AoD

Organ rupture,

PTX/HTX, CCSF

Fillable Fields

18 character limit

phone number only

If any or NKA (No Known Allergies). 18 character limit
Extra Lines (If Necessary)
If you need more space for your allergies or additional contact there are up to 6 additional lines available for engraving on the back of the bracelet. We will cover the cost. 

Limited to 18 Characters and 6 lines