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Get the free PSCIM Reg Form. Emergency Medical Services Requirements for ALS Course Sponsors Gran...

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OCC Public Safety Training Center Credit and Non-credit Registration Form Check (?) the box for the Special Program this registration application is for. Course Name Course Number HSD-152 Credits/Hours
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How to fill out PSCIM reg form emergency:

01
Obtain the PSCIM reg form from the designated authority. This form is typically available online or at the concerned office.
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Start by filling out your personal information accurately. Include your full name, address, phone number, and any other required details.
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Provide the necessary emergency contact information. This should include the name, relationship, phone number, and address of a person who can be contacted in case of emergency.
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Fill in your medical information carefully. Include any pre-existing conditions, allergies, medications currently being taken, and any other relevant details.
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Specify any chronic illnesses or disabilities if applicable. Provide detailed information about your condition, any necessary accommodations, and the name of your primary healthcare provider.
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Indicate your preferred hospital or healthcare facility in case of an emergency. Include its name, address, contact information, and any specific instructions if applicable.
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Sign the form once you have reviewed all the information provided. Make sure to date the form as well.
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Keep a copy of the completed form for your records and submit the original to the appropriate authority or organization.

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