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Birth ID# Mother s Name Father s Name Local Emergency Contact Name: Emergency Phone Number Local Physician s Name Physician s Phone Number 9 10 11 (Circle one) 12 Mother s Contact Numbers: Father s Contact Numbers: Emergency Contact Address: Physician s Address: AUTHORIZATION FOR MEDICAL TREATMENT If neither parent can be contacted, I authorize the school personnel to take such emergency action as may be deemed necessary. I give my consent and permission to any supervisin.

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This form can be downloaded thru the SSS Website at .sss.gov.ph.

and can do so online at: .sss.gov or they can complete this form.

THIS CAN ALSO BE DOWNLOADED THRU THE SSS WEBSITE AT . Fill out this form and submit to the nearest SSS branch office together with the required documents. 2.

THIS CAN ALSO BE DOWNLOADED THRU THE SSS WEBSITE AT . Fill out this form and submit to the nearest SSS branch office together with the required documents. 2.

THIS CAN ALSO BE DOWNLOADED THRU THE SSS WEBSITE AT .sss.gov.ph PLEASE READ THE INSTRUCTIONS AND REMINDER AT THE BACK BEFORE FILLING OUT THIS FORM. PRINT ALL INFORMATION IN CAPITAL LETTERS AND USE BLACK INK ONLY.

THIS FORM MAY BE REPRODUCED AND IS NOT FOR SALE. THIS CAN ALSO BE DOWNLOADED THRU THE SSS WEBSITE AT .sss.gov.ph. FILL OUT THIS FORM IN TWO (2) COPIES. PRINT ALL INFORMATION IN CAPITAL LETTERS AND USE BLACK INK ONLY.

Employers must log in to their My. SSS account, proceed to the E-Services tab and click on "Submit SS Sickness Benefit Reimbursement Application (SBRA)."

SBA Form must be submitted to SSS within five (5) calendar days after the start date of confinement. SBA Form must be submitted to SSS within one (1) year from the date of hospital discharge.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232