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MEDICAL RELEASE / PERMISSION CARD IMMANUEL BAPTIST CHURCH STUDENT MINISTRY 4020 EAST UNIVERSITY BLVD. ODESSA TEXAS 79762 PHONE 432. 550. 5282 FAX 432. 363. 9382 NameDate of Birth //Age Home AddressCityStateZip Parent or Guardian Name Home Phone Dad Work/Cell Phone Mom Work /CellPhone Doctor s Name Insurance CompanyPolicy In the event of an emergency give the name and phone number of friends or relatives we can contact who will know how to reach parents or guardians List known food/drug...

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What is medical release permission card?

The medical release permission card is a document that authorizes a designated individual to make medical decisions on behalf of another person in case they are unable to do so.

Who is required to file medical release permission card?

The medical release permission card is typically required for individuals who have specific medical conditions or who may be at risk of becoming incapacitated.

How to fill out medical release permission card?

To fill out a medical release permission card, you will need to provide information about the designated individual who will make medical decisions, as well as information about the person granting permission.

What is the purpose of medical release permission card?

The purpose of the medical release permission card is to ensure that medical decisions can be made on behalf of a person who is unable to make those decisions themselves.

What information must be reported on medical release permission card?

The medical release permission card typically requires information about the designated individual, the person granting permission, and any specific medical conditions or treatments that need to be considered.

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