Get Health Form - The Lsu Agcenter

The health form for the LSU AgCenter is an essential document required for participation in various events. This guide will provide you with a comprehensive, step-by-step overview on how to fill out the form accurately and efficiently to ensure a smooth registration process.

Follow the steps to complete the health form accurately and efficiently.

1. Press the ‘Get Form’ button to access the health form and open it in your preferred editor.
2. Provide event or activity details in the designated section, including the specific name of the event.
3. Enter the participant's name, including first, middle, and last names, along with their date of birth.
4. Fill in the complete address of the participant, including street address, city, state, zip code, and parish.
5. For youth participants, include the name and contact information of a parent or guardian, specifying home, work, and cell phone numbers.
6. Enter the name of the family physician along with their contact information, including the office phone and an alternate contact number.
7. Provide the health insurance company name and address, along with the group number, policy number, and name of the insured.
8. List two emergency contact names and their contact phone numbers, including home, work, and cell.
9. In the health history section, indicate any known drug allergies and check all applicable past or present health conditions.
10. Provide explanations for any affirmative responses in the health history and list additional health issues or relevant details.
11. Document the latest immunization dates for tetanus and hepatitis.
12. If applicable, list any special or prescription medications, including dosage, frequency, and the prescribing physician's contact information.
13. Outline any special restrictions due to chronic or recurring health issues, and provide dietary modification instructions if necessary.
14. Sign the statement of health, indicating your understanding of your health conditions and readiness to participate.
15. Review your completed form for accuracy before saving changes, downloading, printing, or sharing.

Complete your health form online to ensure your participation in the LSU AgCenter event.