Get 5341 F1page 1 Of 1

The 5341 F1page 1 Of 1 is an emergency medical authorization form designed for parents and guardians to allow for the provision of emergency treatment for children. This guide will walk you through the steps to effectively complete the form online, ensuring that you provide all necessary information for the safety and care of your child.

Follow the steps to accurately complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the student’s information. You will need to fill in their name, date of birth, gender, address, phone number, and grade.
3. Next, provide the mother's contact information including her name, home phone, work phone, and cell/pager number. If her address differs from that of the student, include the different address.
4. Similarly, enter the father's details in the corresponding fields, including his work information and any alternative address.
5. If applicable, fill in the step-mother's and step-father's information in a similar manner, including all necessary contact numbers.
6. List at least three individuals (relatives or neighbors) who may be notified in case of an emergency. Specify each person's relation to the child, along with their contact information.
7. Include the name and phone number of the dentist and doctor to be called in an emergency situation.
8. Indicate the preferred local hospital for emergency treatment.
9. Detail any significant medical history of the child such as allergies or medications currently taken, that should be communicated to a physician.
10. Decide whether to grant consent for emergency medical treatment or refuse consent. If granting consent, provide a signature and date, or if refusing, detail the preferred course of action and sign.
11. After completing all sections, you can save your changes, download the form for printing, or share it accordingly.

Complete your 5341 F1page 1 Of 1 form online today for peace of mind regarding your child's health.