LY Student ID Cell E-Mail Address Faculty/Coordinator Date of Event Course # (if applicable) Emergency Contact Information (Print Clearly) Emergency Contact #1 Emergency Contact 1 Emergency Contact 2 Last, First Name Relationship Street Address City, State, Zip, Country E-Mail Address Phone: Home Language Spoken Phone: Work Language Spoke.
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How to fill out the CSU Chico Emergency Contact & Medical Information online
Completing the CSU Chico Emergency Contact & Medical Information form is an essential step for ensuring your safety and well-being during your time at the university. This guide will provide you with clear, step-by-step instructions to help you fill out the form accurately and efficiently.
Follow the steps to complete your emergency contact and medical information form.
- Press the ‘Get Form’ button to access the form digitally.
- Enter your last and first name in the designated fields provided at the top of the form.
- Indicate whether you are 18 years or older by selecting 'Yes' or 'No'.
- Fill in your birth month and day in the specified section.
- Input your student ID number, cell phone number, and email address accurately.
- Provide your faculty or coordinator's name and the date of the event, if applicable.
- If applicable, enter your course number in the designated spot.
- Complete the emergency contact information sections for two contacts. Include their last and first names, relationship to you, full address (street, city, state, zip, country), email address, and phone numbers (home, work, cell) along with the language they speak.
- Indicate if you have any allergic reactions by checking 'Yes' or 'No' for bee/insect stings, medications, and food/drink. Provide explanations for any 'Yes' answers in the space given.
- State any dietary restrictions you may have by providing details in the corresponding section.
- Sign and date the form, giving consent for your information to be accessed in case of an emergency.
- After completing the form, you can save your changes, download a copy, print it out for your records, or share it as needed.
Take the next step towards your safety by completing the CSU Chico Emergency Contact & Medical Information form online today.
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How to fill out an emergency contact?
When filling out your emergency contact for CSU Chico Emergency Contact & Medical Information, ensure you include your contact's name, their relationship to you, and reliable phone numbers. If possible, also add an alternative contact method, such as an email, to guarantee that emergency personnel can reach them in various ways. Always double-check your entry before finalizing it to avoid any misunderstandings during emergencies.
How do I write an emergency contact?
To write an emergency contact for CSU Chico Emergency Contact & Medical Information, first, introduce the individual's name and their relationship to you. Provide their phone number so that they can be contacted quickly in any situation. It's also helpful to add any additional information, such as their availability or special instructions for how they should be reached.
How to fill out an emergency contact form?
Filling out an emergency contact form for CSU Chico Emergency Contact & Medical Information requires clear and accurate information. Begin with your name and any necessary identification information, then move on to listing your chosen emergency contact's details, including their name, relationship, and contact information. Always review the form for completeness before submission to ensure that all critical details are correct.
What is an example of an emergency contact person?
An example of an emergency contact person is your parent or guardian, as they are typically someone you trust to make important decisions on your behalf. You could also consider a close friend, sibling, or spouse who is familiar with your medical history and can provide assistance in emergencies. The key is to choose someone who can act quickly and effectively in stressful situations related to your CSU Chico Emergency Contact & Medical Information.
How to fill emergency contact details?
To fill out your emergency contact details for CSU Chico Emergency Contact & Medical Information, start by providing the full name of your chosen contact. Next, include their relationship to you, such as parent, friend, or sibling. Finally, ensure you enter their phone number and address accurately so that emergency personnel can reach them without delay.
What is the crisis hotline for Chico State?
Crisis Counselors are available via phone consultation 24/7 for Chico State Students. Please call our main line at 530-898-6345 and press 2 to speak to a counselor.
Do you have to be vaccinated to go to Chico State University?
Vaccination will be required at Chico State to access campus facilities or participate in in-person classes and activities. Am I required to get a COVID-19 booster shot?
What is the phone number for Chico State help?
Phone. Give us a call at 530-898-4357 and we will be more than happy to assist you. For Distance Ed support 800-780-4837, option #3.
What is the COVID hotline for CSU Chico?
If You Are Experiencing COVID-19 Symptoms Call the COVID-19 Hotline at 530-898-2222 to report results. If negative, follow normal sick leave practices until feeling better. If positive, isolate as directed.
What is the phone number for EOP Chico State?
BOOK A VIRTUAL OR IN-PERSON APPOINTMENT NOW. EOP admissions questions - Email eopadm@csuchico.edu or call 530-898-6831 to leave a message.
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