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Name Relationship Phone Number Location work home etc. Physician Dentist Physician s Phone Health Insurance Company Dentist s Phone Policy Group Using judgment the Academy may administer Acetaminophen Tylenol Yes No Ibuprofen Advil/Motrin Yes No In the event of an emergency and neither parent can be reached I hereby authorize school officials to take whatever action is deemed necessary in their judgment for the health of my child ren. I accept responsibility for all costs related to such...
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What is emergency contact form 17?
Emergency contact form 17 is a document that collects information about individuals who should be contacted in case of an emergency.
Who is required to file emergency contact form 17?
All employees are typically required to file emergency contact form 17.
How to fill out emergency contact form 17?
To fill out emergency contact form 17, you will need to provide your name, relationship to the individual, phone number, and any other relevant information.
What is the purpose of emergency contact form 17?
The purpose of emergency contact form 17 is to ensure that employers have up-to-date contact information for individuals who should be notified in case of an emergency.
What information must be reported on emergency contact form 17?
Information such as name, relationship, phone number, and any specific instructions or medical information should be reported on emergency contact form 17.
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