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EMERGENCY CONTACT FORM Read all requirements and instructions. A new form must be submitted if there is a change in information or in the event of a medically related leave of absence. Email the completed

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Open the medical clearance/emergency contact formdocx in a word processing program on your computer.

02

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

03

Provide details about your medical history including allergies, current medications, and any pre-existing conditions.

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Fill in the emergency contact information including name, relationship, and contact number.

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Double check all the information for accuracy and completeness before saving the document or printing it out.

Who needs medical clearanceemergency contact formdocx?

01

Anyone participating in a sports activity, school event, or travel program that requires medical clearance or emergency contact information.

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What is medical clearanceemergency contact formdocx?

Medical clearance/emergency contact formdocx is a document that provides information about an individual's medical history and emergency contacts in case of an emergency.

Who is required to file medical clearanceemergency contact formdocx?

All individuals participating in certain activities or programs may be required to file a medical clearance/emergency contact formdocx.

How to fill out medical clearanceemergency contact formdocx?

To fill out a medical clearance/emergency contact formdocx, individuals need to provide information about their medical history, allergies, medications, and emergency contacts.

What is the purpose of medical clearanceemergency contact formdocx?

The purpose of a medical clearance/emergency contact formdocx is to ensure that individuals participating in activities or programs are medically cleared to do so and that emergency contacts are readily available in case of an emergency.

What information must be reported on medical clearanceemergency contact formdocx?

Information reported on a medical clearance/emergency contact formdocx may include medical history, allergies, current medications, and emergency contact information.

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