Get Emergency Medical Authorization Form - Revere Local Schools

Filling out the Emergency Medical Authorization Form is essential for ensuring that your child's health needs are addressed swiftly in case of an emergency. This guide will provide you with a clear, step-by-step approach to completing the form online.

Follow the steps to successfully complete the form.

1. Use the ‘Get Form’ button to access the Emergency Medical Authorization Form and open it in your preferred editing tool.
2. In the first section, fill in your child's name, date of birth, grade, and school. Don’t forget to provide a contact phone number.
3. Next, enter your email address to ensure you receive important notifications. This enhances communication regarding your child's health during school hours.
4. Complete the section for the mother and father or guardians. Include their names, contact numbers (cell, work, and home), and email addresses.
5. Identify an emergency contact who is not the parents or guardians. Fill in their name, relationship to the child, and all applicable phone numbers.
6. Grant consent by listing preferred medical care providers including the family doctor, dentist, or any specialists. Make sure to include their contact phone numbers.
7. Indicate your preferred hospital for your child’s transport in the event of an emergency. This helps expedite treatment.
8. Provide any relevant medical alerts, including medications, allergies, or past surgeries, to ensure comprehensive care.
9. Sign and date the form at the bottom, confirming your authorization for emergency medical treatment.
10. If you do not consent to emergency treatment, complete the 'Refusal to Consent' section, providing your instructions and signature.
11. Once the form is completed, save any changes you made. You can then download, print, or share the form as needed.

Ensure your child is prepared for any emergencies by completing the Emergency Medical Authorization Form online today.