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Q St. Cecilia School Extended Care Program REGISTRATION 20122013 Dear Parents, If you are interested in enrolling your child×men) in the St. Cecilia Extended Care Program, please fill out both the
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How to fill out extended care registrationdoc
How to Fill Out Extended Care Registration Document:
Start by gathering all the necessary information:
01
Full name of the individual requiring extended care
02
Contact information (phone number, email address, home address)
03
Emergency contact details (name, relationship, phone number)
04
Medical information (any allergies, existing conditions, medications)
05
Previous medical history (if applicable)
06
Insurance information (policy number, provider details)
6.1
Carefully read through each section of the extended care registration document to understand the required information.
6.2
Begin filling out the form section by section, ensuring accuracy and clarity in your responses.
6.3
Personal Information: Provide the individual's full name, date of birth, gender, and any other requested personal details.
6.4
Contact Information: Enter the individual's current address, phone number, and email address.
6.5
Emergency Contact Details: Include the name, relationship, and phone number of at least one emergency contact.
6.6
Medical Information: Specify any allergies, existing medical conditions, and medications the individual may be taking. If necessary, provide additional details regarding the severity of allergies or the management of specific conditions.
6.7
Previous Medical History: If the individual has any relevant medical history, such as previous surgeries or ongoing treatments, disclose this information in the appropriate section.
6.8
Insurance Information: Fill in the details of the individual's insurance policy, including the policy number and the name of the insurance provider.
6.9
Read the completed form thoroughly to ensure all information is accurate and filled out correctly.
6.10
Sign and date the document where indicated.
6.11
Finally, submit the extended care registration document to the appropriate authority or institution, as per the provided instructions.
Who Needs Extended Care Registration Document:
01
Individuals who require extended care services, such as those with chronic illnesses, disabilities, or elderly individuals needing assistance with daily activities.
02
Parents or legal guardians of minors who require extended care services.
03
Anyone seeking admission or enrolling in a facility or program that offers extended care services, such as nursing homes, assisted living facilities, or rehabilitation centers.
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