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MOBILE BOTANICAL GARDENSSTEAM AT THE GARDENSHealth/Emergency Contact Form (Three Pages) (Complete a separate form for each participant) Participant Name ___ Date of Birth ___ Age ___Sex ___Person
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Download the adsa-emergency-contact-medical-release-formpdf from the website.
02
Fill out the patient's name, date of birth, and contact information.
03
Provide the name and contact information of the emergency contact.
04
Review the medical conditions, allergies, and medications section and fill out as necessary.
05
Sign and date the form to authorize release of medical information in case of emergency.
06
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Anyone who wants to ensure that their emergency contact and medical information are readily available in case of an emergency should fill out adsa-emergency-contact-medical-release-formpdf.
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adsa-emergency-contact-medical-release-formpdf is a form that contains emergency contact information and medical release authorization.
Parents or guardians of minors are required to file adsa-emergency-contact-medical-release-formpdf.
To fill out adsa-emergency-contact-medical-release-formpdf, you need to provide emergency contact information and authorize medical treatment for the minor.
The purpose of adsa-emergency-contact-medical-release-formpdf is to ensure that caregivers have necessary information and authorization in case of medical emergency involving a minor.
Information such as emergency contacts, medical conditions, allergies, and authorizations for medical treatment must be reported on adsa-emergency-contact-medical-release-formpdf.
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