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This form is intended to help Nipissing International Department and the University Physician provide appropriate assistance to students during their Education Abroad experience by gathering necessary
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How to fill out NU PERSONAL HEALTH EMERG FORM

01
Obtain the NU PERSONAL HEALTH EMERG FORM from a healthcare provider or download it from the official website.
02
Provide your full name at the top of the form.
03
Fill in your date of birth and contact information including phone number and address.
04
Indicate your emergency contact person's name and their phone number.
05
List any known allergies or medical conditions in the specified sections.
06
Provide information about your current medications, including dosage and frequency.
07
Sign and date the form to confirm that the information provided is accurate.
08
Submit the completed form to your healthcare provider or keep it with your medical records.

Who needs NU PERSONAL HEALTH EMERG FORM?

01
Individuals who want to ensure their medical information is accessible in case of an emergency.
02
Parents or guardians of minors who require medical treatment.
03
Caregivers or family members of those with chronic illnesses who may require immediate medical assistance.
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The NU PERSONAL HEALTH EMERG FORM is a medical document used to collect essential information regarding an individual's health status in emergency situations.
Individuals who wish to have their health information readily available in emergency situations, such as patients, caregivers, or guardians, are required to file the NU PERSONAL HEALTH EMERG FORM.
To fill out the NU PERSONAL HEALTH EMERG FORM, provide personal identification details, medical history, current medications, allergies, and emergency contact information in the designated fields.
The purpose of the NU PERSONAL HEALTH EMERG FORM is to ensure that first responders and healthcare professionals have immediate access to crucial health information during emergencies, facilitating timely and appropriate care.
The information that must be reported on the NU PERSONAL HEALTH EMERG FORM includes the individual’s name, contact information, medical history, current medications, allergies, pre-existing conditions, and a list of emergency contacts.
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