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Emergency Medical Authorization This form meets the requirement for Ohio Revised Code Section 3313.712. Program Name:C.O.P.S. DRIVING ACADEMY, INC Student Name ___ Phone ___ Address___ Purpose To

How to fill out emergency medical authorization form

How to fill out emergency medical authorization form

1. Gather all necessary personal information (full name, date of birth, address, contact numbers)
2. Include any existing medical conditions, allergies, or medications being taken
3. Specify emergency contacts and their contact numbers
4. Sign and date the form at the bottom

Who needs emergency medical authorization form?

1. Parents of minors
2. Guardians of minors
3. Schools for field trips or extracurricular activities
4. Sports coaches
5. Employers for employees working in potentially hazardous environments

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What is emergency medical authorization form?

Emergency medical authorization form is a legal document that grants permission to a designated individual to make medical decisions on behalf of someone else in case of an emergency.

Who is required to file emergency medical authorization form?

Parents, guardians, or individuals responsible for the care of a minor or incapacitated person are typically required to file an emergency medical authorization form.

How to fill out emergency medical authorization form?

To fill out an emergency medical authorization form, you need to provide personal information, emergency contact details, medical history, and authorization for medical treatment.

What is the purpose of emergency medical authorization form?

The purpose of an emergency medical authorization form is to ensure that necessary medical decisions can be made swiftly and accurately during an emergency situation.

What information must be reported on emergency medical authorization form?

Information such as full name, date of birth, medical conditions, allergies, current medications, emergency contacts, insurance information, and consent for treatment must be reported on an emergency medical authorization form.