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Form A: Emergency Medical Release and Health Information for Youth (Rev. 2/2019)Name/Address of Diocesan Institution Sponsoring Program/Activity ROMAN CATHOLIC DIOCESE OF OWENSBORO, 600 Locust St.,

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How to fill out emergency medical release and

01

Step 1: Start by collecting all the necessary information about the individual requiring the emergency medical release.

02

Step 2: Begin filling out the emergency medical release form by entering the individual's full name, date of birth, and contact information.

03

Step 3: Provide details about the individual's medical history, including any existing medical conditions, allergies, and medications they are currently taking.

04

Step 4: Include the contact information of the individual's primary healthcare provider or physician.

05

Step 5: Indicate any specific medical procedures or treatments that the individual may require in case of an emergency.

06

Step 6: Include any additional emergency contact information, such as family members or close friends who should be notified in case of an emergency.

07

Step 7: Review the completed emergency medical release form for accuracy and completeness before signing and dating it.

08

Step 8: Make copies of the signed form and distribute them to relevant parties, such as schools, sports teams, or caregivers.

Who needs emergency medical release and?

01

The emergency medical release is typically needed for individuals who may require emergency medical treatment or assistance in certain situations.

02

This includes individuals with known medical conditions, allergies, or those who are taking medications that could have potential adverse reactions.

03

It is especially important for individuals who participate in activities or programs where there is a risk of injury or medical emergencies, such as sports teams, summer camps, or school field trips.

04

Parents or legal guardians often need to fill out emergency medical release forms for their children, ensuring that necessary medical information is readily available in case of an emergency.

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What is emergency medical release?

Emergency medical release is a form that authorizes medical treatment for an individual in case of an emergency.

Who is required to file emergency medical release?

Parents or legal guardians of minors are typically required to file emergency medical release forms.

How to fill out emergency medical release?

Emergency medical release forms can be filled out by providing personal information, emergency contacts, medical information, and signatures.

What is the purpose of emergency medical release?

The purpose of emergency medical release is to ensure that medical providers have authorization to provide necessary treatment in case of an emergency.

What information must be reported on emergency medical release?

Information such as medical conditions, allergies, medications, emergency contacts, insurance information, and consent for treatment must be reported on emergency medical release forms.

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