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East Tennessee Children's Hospital Gastroenterology and Nutrition Services Medical Office Building 2100 Clinch Avenue, Suite 510, Knoxville, TN 37916 Phone: 865/5463998 Fax: 865/5461123 Emergency

How to fill out patient information emergency contact

How to fill out patient information emergency contact:

1. Begin by locating the designated area on the patient information form for emergency contact details. This is typically found towards the beginning or end of the form.
2. Provide the full name of the individual who should be contacted in case of an emergency. Make sure to include their first name, last name, and any applicable titles (e.g., Mr., Mrs., Dr.).
3. Include the relationship of the emergency contact to the patient. This could be a spouse, parent, sibling, friend, or any other relevant connection.
4. Enter the phone number of the emergency contact. If possible, provide both a primary and secondary phone number to increase the chances of reaching them in case of an emergency.
5. Provide an alternative contact number, if available. This could be the emergency contact's work number, a cell phone number, or any other number where they can be reached.
6. If applicable, include the email address of the emergency contact. This can be useful in certain situations where email communication may be necessary.
7. In case the emergency contact is unavailable, it is advisable to provide an additional alternative contact person. Repeat steps 2-6 for this alternate contact.
8. Double-check all the information you have entered for accuracy before submitting the form.

Who needs patient information emergency contact:

1. Healthcare providers: Doctors, nurses, and other medical professionals require emergency contact information to ensure timely communication with a patient's loved ones in case of emergencies or critical situations.
2. Hospitals and clinics: Emergency departments and medical facilities need this information to contact a patient's emergency contact if immediate authorization or consent is required for medical procedures or decisions.
3. Insurance companies: In situations where insurance coverage is involved, insurance companies may require patient information emergency contact to reach out to a reliable point of contact in case of any necessary communication or coordination.

Remember, providing accurate and up-to-date emergency contact information is crucial for the well-being and safety of the patient.

For pdfFiller’s FAQs

What is patient information emergency contact?

Patient information emergency contact is the contact information of an individual to be reached in case of a medical emergency involving the patient.

Who is required to file patient information emergency contact?

Healthcare providers, hospitals, clinics, and other medical facilities are required to file patient information emergency contact.

How to fill out patient information emergency contact?

Patient information emergency contact can be filled out by providing the name, relationship, phone number, and address of the emergency contact person.

What is the purpose of patient information emergency contact?

The purpose of patient information emergency contact is to ensure that medical providers can quickly reach someone who is authorized to make medical decisions on behalf of the patient in case of an emergency.

What information must be reported on patient information emergency contact?

Patient information emergency contact must include the name, relationship, phone number, and address of the emergency contact person.

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