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AUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATION/ EMERGENCY CONTACT ONLY This authorization for use or disclosure of medical information complies with the terms of the Confidentiality of Medical

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How to fill out emergency contact release form

01

Start by opening the emergency contact release form.

02

Fill in your personal information, such as your full name, date of birth, and address.

03

Provide the contact details of at least two emergency contacts. This should include their full names, phone numbers, and relationships to you.

04

Read the terms and conditions carefully before signing the form.

05

Sign and date the form at the designated space.

06

Make a copy of the completed form for your records.

07

Submit the form to the appropriate authority or organization that requires it.

Who needs emergency contact release form?

01

Emergency contact release forms are typically required by various organizations and institutions, including:

02

- Schools and universities

03

- Daycare centers

04

- Summer or sports camps

05

- Employers

06

- Medical facilities

07

- Legal guardians or caretakers

08

- Sports organizations or teams

09

- Travel agencies or tour operators

10

- Volunteer programs

11

- Non-profit organizations

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