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THE SCHOOL BOARD OF SARASOTA COUNTY, FLORIDA 1960 LANDINGS BOULEVARD, SARASOTA, FL 34231 PHONE (941) 9279000 EMERGENCY MEDICAL/TREATMENT CONSENT FOR FIELD TRIPS AND/OR OTHER AFTER SCHOOL ACTIVITIES
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Start by filling out the patient's personal information including full name, date of birth, and contact information.
02
Specify the type of emergency medical treatment being sought and provide details about the nature of the emergency.
03
List any pre-existing medical conditions or allergies that the patient may have.
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Provide information about any medications that the patient is currently taking.
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Anyone who is seeking emergency medical treatment and requires documentation of their treatment and medical history.
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063-96-dis emergency medical treatment is a form used to report emergency medical treatment provided to an injured or ill individual.
Healthcare providers and facilities are required to file 063-96-dis emergency medical treatment.
To fill out 063-96-dis emergency medical treatment, you need to provide detailed information about the emergency medical treatment provided, including the patient's information, the treatment administered, and any follow-up care recommended.
The purpose of 063-96-dis emergency medical treatment is to document and report emergency medical treatment provided to individuals in need of immediate medical attention.
Information such as the patient's name, date of birth, the nature of the emergency, treatment provided, medications administered, and any follow-up care instructions must be reported on 063-96-dis emergency medical treatment form.
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