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777 Long Road, Pickering ton, Ohio 43147. Phone: 614-833-2110 Fax: 614-833- 2143 www.pickerington.k12.oh.us. EMERGENCY MEDICAL AUTHORIZATION.
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How to fill out emergency medical authorization form

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Step 1: Obtain a copy of the emergency medical authorization form.
02
Step 2: Fill in the personal information section, including the full name, date of birth, and contact information of the person authorizing the medical treatment.
03
Step 3: Provide the name and contact information of the emergency contacts who should be notified in case of a medical emergency.
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Step 4: Specify any known medical conditions, allergies, or medications that the person authorizing the treatment may have.
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Step 5: Indicate any specific medical treatments or procedures that the person authorizing the treatment consents to or refuses.
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Step 6: Sign and date the form to acknowledge consent and understanding.
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Step 7: Ensure that the completed form is easily accessible in case of an emergency.

Who needs emergency medical authorization form?

01
Parents or legal guardians of minors who may require medical treatment in case of an emergency.
02
Individuals with specific medical conditions or allergies that may require immediate medical intervention whenever necessary.
03
People who frequently engage in high-risk activities or occupations, such as athletes, adventure enthusiasts, or individuals working in hazardous environments.
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