diff --git a/prisma/migrations/0331_emergency_profile/migration.sql b/prisma/migrations/0331_emergency_profile/migration.sql
new file mode 100644
index 000000000..3d0e0e9a1
--- /dev/null
+++ b/prisma/migrations/0331_emergency_profile/migration.sql
@@ -0,0 +1,28 @@
+-- Emergency ("Notfalldaten") facts on the health profile.
+--
+-- Additive only. No table is dropped or restructured: three new enum types and
+-- six new nullable columns fold into the existing `user_health_profiles` row,
+-- one row per user. The three enums are plaintext closed sets read directly by
+-- the doctor-report emergency page (the same shape `User.gender` uses); the
+-- three BYTEA columns hold AES-256-GCM ciphertext, fail-closed on read like
+-- every other `*_encrypted` column. Every column is nullable, so an account
+-- that never fills in an emergency profile carries six NULLs and nothing
+-- surfaces.
+
+-- CreateEnum
+CREATE TYPE "emergency_blood_type" AS ENUM ('A_POS', 'A_NEG', 'B_POS', 'B_NEG', 'AB_POS', 'AB_NEG', 'O_POS', 'O_NEG', 'UNKNOWN');
+
+-- CreateEnum
+CREATE TYPE "organ_donor_status" AS ENUM ('YES', 'NO', 'UNKNOWN');
+
+-- CreateEnum
+CREATE TYPE "advance_directive_status" AS ENUM ('EXISTS', 'NONE', 'UNKNOWN');
+
+-- AlterTable
+ALTER TABLE "user_health_profiles"
+    ADD COLUMN "emergency_blood_type" "emergency_blood_type",
+    ADD COLUMN "organ_donor_status" "organ_donor_status",
+    ADD COLUMN "advance_directive_status" "advance_directive_status",
+    ADD COLUMN "emergency_contacts_encrypted" BYTEA,
+    ADD COLUMN "emergency_implants_encrypted" BYTEA,
+    ADD COLUMN "emergency_note_encrypted" BYTEA;
diff --git a/prisma/schema.prisma b/prisma/schema.prisma
index a84c51351..3c1597a60 100644
--- a/prisma/schema.prisma
+++ b/prisma/schema.prisma
@@ -5945,6 +5945,19 @@ model UserHealthProfile {
   // The static default preserves every pre-existing prompt section for legacy
   // rows without automatically opting future enum members in.
   aiIncludedSections        HealthProfileAiSection[] @default([ABOUT_ME, CONDITIONS, ALLERGIES, COACH_FOCUS, FAMILY_HISTORY, SMOKING_STATUS, ALCOHOL_PATTERN, SHIFT_SCHEDULE]) @map("ai_included_sections")
+  // Emergency ("Notfalldaten") facts, surfaced on page one of the doctor
+  // report and edited in Settings -> Anamnese. Three closed-set enums are
+  // plaintext (read directly by the report, like `User.gender`); three free
+  // text columns are AES-256-GCM at rest, fail-closed on read like every other
+  // `*Encrypted` column. All six are nullable: an unset emergency profile is
+  // absent, not empty. The report page is withheld unless the EMERGENCY leaf is
+  // admitted AND at least one of these holds a value.
+  emergencyBloodType     EmergencyBloodType?     @map("emergency_blood_type")
+  organDonorStatus       OrganDonorStatus?       @map("organ_donor_status")
+  advanceDirectiveStatus AdvanceDirectiveStatus? @map("advance_directive_status")
+  emergencyContactsEncrypted Bytes?              @map("emergency_contacts_encrypted")
+  emergencyImplantsEncrypted Bytes?              @map("emergency_implants_encrypted")
+  emergencyNoteEncrypted     Bytes?              @map("emergency_note_encrypted")
   createdAt                 DateTime                 @default(now()) @map("created_at")
   updatedAt                 DateTime                 @updatedAt @map("updated_at")
 
@@ -5953,6 +5966,42 @@ model UserHealthProfile {
   @@map("user_health_profiles")
 }
 
+/// ABO/Rh blood group, plus an explicit UNKNOWN so "not known" is a recorded
+/// answer rather than an absent row. Plaintext, read directly by the emergency
+/// report page.
+enum EmergencyBloodType {
+  A_POS
+  A_NEG
+  B_POS
+  B_NEG
+  AB_POS
+  AB_NEG
+  O_POS
+  O_NEG
+  UNKNOWN
+
+  @@map("emergency_blood_type")
+}
+
+/// Organ-donor declaration. UNKNOWN is the explicit "not stated" answer.
+enum OrganDonorStatus {
+  YES
+  NO
+  UNKNOWN
+
+  @@map("organ_donor_status")
+}
+
+/// Whether an advance directive (Patientenverfügung) exists. UNKNOWN is the
+/// explicit "not stated" answer.
+enum AdvanceDirectiveStatus {
+  EXISTS
+  NONE
+  UNKNOWN
+
+  @@map("advance_directive_status")
+}
+
 /// Sections of the health profile that may enter AI prompt context. This is an
 /// inclusion list: a section absent from the array is neither decrypted nor
 /// assembled for Coach or comprehensive briefings.
diff --git a/tests/integration/emergency-profile-migration.test.ts b/tests/integration/emergency-profile-migration.test.ts
new file mode 100644
index 000000000..17ef79abd
--- /dev/null
+++ b/tests/integration/emergency-profile-migration.test.ts
@@ -0,0 +1,91 @@
+/**
+ * Migration 0331 shape check, against the real migrated Postgres.
+ *
+ * The testcontainer applies every migration on boot, so this asserts the
+ * three enum types and the six nullable columns migration 0331 adds actually
+ * exist on the live schema. A migration that never ran, or one that named a
+ * column differently from the Prisma model, turns this red before any feature
+ * test that depends on the columns runs.
+ */
+import { describe, expect, it } from "vitest";
+
+import { getPrismaClient } from "./setup";
+
+describe("migration 0331 — emergency profile schema", () => {
+  it("adds the six nullable emergency columns to user_health_profiles", async () => {
+    const rows = await getPrismaClient().$queryRawUnsafe<
+      Array<{ column_name: string; is_nullable: string; data_type: string }>
+    >(
+      `SELECT column_name, is_nullable, data_type
+         FROM information_schema.columns
+        WHERE table_name = 'user_health_profiles'
+          AND column_name IN (
+            'emergency_blood_type',
+            'organ_donor_status',
+            'advance_directive_status',
+            'emergency_contacts_encrypted',
+            'emergency_implants_encrypted',
+            'emergency_note_encrypted'
+          )
+        ORDER BY column_name`,
+    );
+
+    const byName = new Map(rows.map((r) => [r.column_name, r]));
+    for (const col of [
+      "emergency_blood_type",
+      "organ_donor_status",
+      "advance_directive_status",
+      "emergency_contacts_encrypted",
+      "emergency_implants_encrypted",
+      "emergency_note_encrypted",
+    ]) {
+      expect(byName.get(col), `${col} is missing`).toBeDefined();
+      expect(byName.get(col)!.is_nullable, `${col} must be nullable`).toBe(
+        "YES",
+      );
+    }
+    expect(byName.get("emergency_contacts_encrypted")!.data_type).toBe("bytea");
+    expect(byName.get("emergency_blood_type")!.data_type).toBe("USER-DEFINED");
+  });
+
+  it("creates the three emergency enum types with their members", async () => {
+    const rows = await getPrismaClient().$queryRawUnsafe<
+      Array<{ typname: string; enumlabel: string }>
+    >(
+      `SELECT t.typname, e.enumlabel
+         FROM pg_type t
+         JOIN pg_enum e ON e.enumtypid = t.oid
+        WHERE t.typname IN (
+          'emergency_blood_type',
+          'organ_donor_status',
+          'advance_directive_status'
+        )
+        ORDER BY t.typname, e.enumsortorder`,
+    );
+
+    const byType = new Map<string, string[]>();
+    for (const r of rows) {
+      (byType.get(r.typname) ?? byType.set(r.typname, []).get(r.typname)!).push(
+        r.enumlabel,
+      );
+    }
+
+    expect(byType.get("emergency_blood_type")).toEqual([
+      "A_POS",
+      "A_NEG",
+      "B_POS",
+      "B_NEG",
+      "AB_POS",
+      "AB_NEG",
+      "O_POS",
+      "O_NEG",
+      "UNKNOWN",
+    ]);
+    expect(byType.get("organ_donor_status")).toEqual(["YES", "NO", "UNKNOWN"]);
+    expect(byType.get("advance_directive_status")).toEqual([
+      "EXISTS",
+      "NONE",
+      "UNKNOWN",
+    ]);
+  });
+});