Get the free Emergency Information Form b2013b14 - Community School - communityschool

Community School Emergency Information & Child Registration Form Please print clearly and complete all sections. Child's Name Nickname Sex Age D.O.B. Address Home Phone Chronic physical problems/pertinent

How to fill out emergency information form b2013b14

How to fill out emergency information form b2013b14:

1. Begin by clearly printing your personal information, including your full name, date of birth, and contact details.
2. Specify your emergency contact person(s) and provide their names, phone numbers, and relationship to you.
3. Indicate any known medical conditions or allergies that you have, along with the necessary details and any medications you currently take.
4. Provide information regarding your primary healthcare provider, including their name, phone number, and address.
5. If applicable, mention any specialized healthcare providers you see regularly, such as a cardiologist or allergist, along with their contact details.
6. Mention any preferred hospitals or medical facilities that you would like to be taken to in case of an emergency.
7. If you have any specific wishes or preferences in regards to medical treatment, such as a do-not-resuscitate order, clearly state them.
8. Sign and date the form to validate its authenticity.

Who needs emergency information form b2013b14:

1. Individuals living alone or those who often find themselves in situations where they require medical assistance should have this form filled out.
2. It is highly recommended for individuals with chronic medical conditions or complex medical histories to have an emergency information form.
3. Parents or guardians should fill out this form for minors or dependents who are not yet capable of providing their own emergency information.
4. Individuals participating in high-risk activities or occupations, such as extreme sports or military service, should have this form completed.
5. Senior citizens or those with a higher risk of medical emergencies are strongly advised to have an emergency information form in place.
6. Anyone who wants to ensure that healthcare providers have access to critical medical information during emergency situations can benefit from this form.

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