Get Greene County Career Center

Filling out the GREENE COUNTY CAREER CENTER emergency medical authorization form is an important step in ensuring that your child receives appropriate care in the event of an emergency. This guide provides a clear, step-by-step approach to help you navigate the form and complete it successfully.

Follow the steps to complete the emergency medical authorization form.

1. Click the ‘Get Form’ button to access the emergency medical authorization form and open it for completion.
2. Begin by entering the student’s full name in the designated field labeled ‘Student Name’.
3. Fill in the ‘Birthdate’ section with the student’s date of birth.
4. Provide the full address of the student in the ‘Address’ field.
5. In the ‘Parents or Guardians’ section, list the names and daytime phone numbers of all parents or guardians authorized to make medical decisions.
6. Under ‘Other Emergency Contacts’, add additional names and their corresponding daytime phone numbers, ensuring that these contacts are available to respond in an emergency.
7. Select either Part I or Part II to grant or refuse consent for medical treatment. Complete Part I if you agree to emergency medical treatment, providing details for your child's medical care providers and emergency contacts.
8. If completing Part I, sign and date the form where indicated, confirming your consent and understanding of the authorization's scope.
9. If opting for Part II, clearly state your wishes regarding emergency treatment and provide a signature and date as indicated.
10. Review all the information entered for accuracy before finalizing the form.
11. Once satisfied with the details, you can save changes, download, print, or share the completed form as required.

Complete and submit your emergency medical authorization form online to ensure your child's safety.