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BH 75 Mason Street Greenwich, CT 06830 (203) 6299059 Emergency Information Record and Alternate Pickup Form 2015 / 2016 (Please print or type clearly, and include any other information which is not
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01
Gather all necessary personal information such as full name, date of birth, address, and contact details.
02
Include important medical information like allergies, chronic conditions, and prescribed medications.
03
Specify emergency contacts with their full names, phone numbers, and relationships to you.
04
Indicate any specific instructions for emergency responders, such as preferred hospital or medical history details.
05
Keep your emergency information record updated and easily accessible in case of any emergencies.
06
Ensure that the record is stored securely and only shared with authorized individuals or medical professionals.

Who needs emergency information record and?

01
Anyone who has a medical condition or allergy that could potentially require immediate attention in case of an emergency.
02
People with chronic illnesses or ongoing medical treatments should have an emergency information record.
03
Individuals who participate in high-risk activities like extreme sports or adventure travel should also have one.
04
Parents should create an emergency information record for their children with relevant medical and contact details.
05
Senior citizens or individuals with age-related health concerns would benefit from having their emergency information easily accessible.
06
It is recommended for everyone to have an emergency information record to ensure prompt and accurate medical care in emergencies.
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Emergency information record is a document that contains important information about an individual's emergency contacts, medical history, and any specific instructions in case of an emergency.
Individuals who want to ensure their emergency contacts and medical information are easily accessible in case of an emergency are required to file an emergency information record.
To fill out an emergency information record, individuals should provide their contact information, emergency contacts' information, medical history, and any specific instructions for emergency responders.
The purpose of an emergency information record is to provide essential information to emergency responders in case of an emergency, helping them make informed decisions and ensure the individual receives appropriate care.
Emergency information record must include contact information, emergency contacts' information, medical history, allergies, medications, and any specific instructions for emergency responders.
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