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ProgramEmergencyInformation: SCHOOL/AGENCYINDIVIDUALPLACEMENTS Program Name: Director(s) in Charge: DONE BEFOREBEGINNINGSERVICE IsyourservicesiteontheApprovedSitelist? Ifs:Notify. E.S. Coordinatoroftheseplacements
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How to fill out program emergency information
How to fill out program emergency information
01
Gather all necessary information such as full name, address, date of birth, and contact details of the person filling out the form.
02
Include any pre-existing medical conditions or allergies that the individual may have.
03
Provide emergency contact information, including names, phone numbers, and relationships to the person filling out the form.
04
Ensure you have relevant medical insurance details and policy numbers.
05
Include any medications the person may be taking and specific instructions for emergency responders or medical personnel.
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Specify any special instructions or considerations, such as dietary restrictions or mobility issues.
07
Review the filled-out form for accuracy and completeness.
08
Keep a copy of the program emergency information in a safe and easily accessible location.
09
Update the information periodically or whenever there are significant changes in the person's health or contact details.
Who needs program emergency information?
01
Anyone participating in a program or activity that involves potential health or safety risks.
02
Individuals with medical conditions that may require immediate attention or specific treatments.
03
People with allergies or sensitivities that could lead to adverse reactions in emergency situations.
04
Children or minors who may not be able to communicate their medical needs effectively.
05
Individuals who engage in outdoor or physical activities where accidents or injuries can occur.
06
Employees or staff members responsible for the safety and well-being of program participants.
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