Get the free EMERGENCY CONTACT/INSURANCE FORM - grandview

This document gathers emergency contact and medical insurance information for student-athletes at Grand View University, to be submitted prior to participation in athletics.

How to fill out emergency contactinsurance form

How to fill out EMERGENCY CONTACT/INSURANCE FORM

1. Begin by reading the instructions on the form carefully.
2. Fill in your personal information such as your full name, date of birth, and address.
3. Provide your primary insurance information, including the provider's name, policy number, and group number.
4. List your emergency contacts, including their full names, relationships to you, and contact numbers.
5. Indicate any medical conditions or allergies that emergency personnel should be aware of.
6. Review all the information for accuracy before signing and dating the form.
7. Submit the completed form as instructed, either in person or electronically.

Who needs EMERGENCY CONTACT/INSURANCE FORM?

1. Any individual who may require medical assistance or emergency treatment, including patients at healthcare facilities, students in schools, and attendees at events or organizations.

People Also Ask about

What should be included in an emergency?

This kit should include the following: Water. One gallon per day, per person. Food. Include pet food, if applicable. Handheld AM/FM radio and NOAA Weather Tone Alert Radio. Cellular phone. Chargers for portable electronic devices (phone, laptop, tablet, etc.) Flashlight and appropriate spare batteries. First aid kit.

What should be included in an emergency contact?

The ideal emergency contact is able to talk to medical professionals about medical history, allergies, chronic conditions, and current medications. In some cases, they even make medical decisions for their loved one.

What to include in an emergency contact list?

Here are seven recommended items that you may want to include on your emergency contact list. Your business information. Your facility manager. Your employees. Your insurance company. Emergency services. Utility companies. Other numbers.

How to fill out an emergency contact form?

Emergency contact form template Employee's personal information. Name: Position/department: Emergency contacts. Primary contact name: Relationship to you: Medical information. The following medical information is voluntary, but it may help with an appropriate response in an emergency situation. Primary care physician:

How do I list someone as an emergency contact?

Add your emergency info. For Medical information: Tap Medical information. To add info like blood type, allergies, or medications, tap the item in the list you want to update. For Emergency contacts: Tap Emergency contacts. Add contact and choose the existing contact you want to add.

Who should I list as an emergency contact?

Having an emergency contact list can make navigating an unexpected event as clear and efficient as possible. When choosing your emergency contact, consider family members or friends who live locally and who you trust to make hard decisions on your behalf.

How to write emergency contact details?

An Emergency Contact Form is a document that contains essential information about an individual's designated point of contact in case of an emergency. This form typically includes the contact person's name, relationship to the individual, phone number, address, and other crucial details.

What do you put in your phone for emergency contact?

Add an emergency contact in your phone, such as a parent, spouse or close friend who can come to your aid. If your phone locks, set up a lock screen message to communicate helpful information to first responders, like your emergency contact, blood type, allergies and medications.

For pdfFiller’s FAQs

What is EMERGENCY CONTACT/INSURANCE FORM?

The EMERGENCY CONTACT/INSURANCE FORM is a document used to collect information about an individual's emergency contacts and insurance details in case of an emergency situation.

Who is required to file EMERGENCY CONTACT/INSURANCE FORM?

Typically, individuals such as students, employees, or participants in certain programs or events are required to file the EMERGENCY CONTACT/INSURANCE FORM.

How to fill out EMERGENCY CONTACT/INSURANCE FORM?

To fill out the EMERGENCY CONTACT/INSURANCE FORM, you should provide accurate personal information, including your name, contact details, the names and relationships of emergency contacts, and your insurance policy information.

What is the purpose of EMERGENCY CONTACT/INSURANCE FORM?

The purpose of the EMERGENCY CONTACT/INSURANCE FORM is to ensure that emergency personnel can quickly reach designated contacts and access insurance information during times of crisis.

What information must be reported on EMERGENCY CONTACT/INSURANCE FORM?

The information that must be reported includes the individual's name, address, phone number, emergency contact names and numbers, and insurance provider details including policy number.