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Office of Student Health and Wellness 42 West Madison Chicago, Illinois 60602 Telephone: 7735533520 Fax: 7735531883 Office Use Only Reviewed by: Follow up: Documents received: Information mica Del
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How to fill out informacin mdica del estudiante:
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Start by providing the student's personal information, such as their full name, date of birth, and contact details.
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Next, indicate the student's medical history, including any pre-existing conditions, allergies, or chronic illnesses they may have.
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Specify any medications that the student takes regularly, along with the dosage and frequency.
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Include emergency contact information, including the names and phone numbers of parents or guardians who should be notified in case of an emergency.
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Note any specific medical instructions or restrictions that should be followed for the student, such as dietary restrictions, physical activity limitations, or required medical procedures.
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Finally, review the completed form for accuracy and sign it to indicate that the information provided is true and accurate.
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