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FORMULA IRE D\'AUTHORIZATION MEDICAL D\'URGENCY O.R.C. 33313.712 COLUMBUS CITY SCHOOLSADRESSE:___ NU MRO DE PHONE:___ COLE:___ PARENT OF TUT EUR (THRICE) RESIDENTIAL NO MDE LA MRE:___NOT DU PRE:___
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Specify the emergency contact person, their relationship to the patient, and their contact information.
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Fill in the details of the patient's primary healthcare provider, including their name, address, and phone number.
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Formulaire d'autorisation médicale d'urgence is a medical authorization form that allows medical professionals to provide emergency medical treatment to an individual.
This form is typically required to be filed by individuals who have specific medical conditions or allergies that may require urgent medical attention.
To fill out the form, individuals need to provide their personal information, medical history, any medications they are currently taking, emergency contact information, and any specific medical instructions or conditions.
The purpose of the form is to ensure that medical professionals have necessary information to provide appropriate and timely emergency medical treatment to the individual in case of an emergency.
Information such as the individual's name, date of birth, known medical conditions, allergies, current medications, emergency contact information, and any specific medical instructions must be reported on the form.
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