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This document is designed to collect emergency contact and medical information for students enrolled in Brockton Community Schools to ensure their safety and proper care in emergencies.
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How to fill out confidential student emergency information

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How to fill out Confidential Student Emergency Information Form

01
Obtain the Confidential Student Emergency Information Form from your school or educational institution.
02
Fill in the student's full name at the top of the form.
03
Provide the student's date of birth and grade level.
04
Enter the parent's or guardian's name, relationship to the student, and emergency contact number.
05
List any medical conditions or allergies the student may have.
06
Include the name and phone number of the student's doctor or pediatrician.
07
Provide an additional contact person and their phone number in case the primary contact cannot be reached.
08
Sign and date the form to confirm that all information is accurate and up-to-date.
09
Submit the completed form to the school office or designated authority.

Who needs Confidential Student Emergency Information Form?

01
Parents or guardians of students who attend school.
02
Schools or educational institutions to ensure student safety in emergencies.
03
Emergency personnel who may need information about the student in case of an emergency.
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The Confidential Student Emergency Information Form is a document designed to provide vital information about a student in case of an emergency, ensuring that school officials can act swiftly to address the student's needs.
Typically, all students enrolled in a school or educational institution are required to file the Confidential Student Emergency Information Form to ensure their safety and well-being.
To fill out the Confidential Student Emergency Information Form, parents or guardians should provide accurate personal and contact information, details about medical conditions, allergies, emergency contacts, and any other pertinent information requested on the form.
The purpose of the Confidential Student Emergency Information Form is to collect essential information that can be used by school officials in the event of an emergency, ensuring the appropriate response for the student's safety and health.
The information that must be reported on the Confidential Student Emergency Information Form typically includes the student's full name, date of birth, medical conditions, allergies, medications, emergency contact information, and any other specific instructions related to the student's care.
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