Get Medical Emergency Form - University Of Michigan - Lsa Umich

Filling out the Medical Emergency Form for the University of Michigan is a crucial step for students concerned that their medical condition may affect their performance during examinations. This guide provides comprehensive instructions to ensure that you complete the form accurately and efficiently online.

Follow the steps to complete the Medical Emergency Form online.

1. Press the ‘Get Form’ button to access the Medical Emergency Form, allowing you to view and edit it online.
2. Begin by completing the section designated for the student. Fill in your full name, ensuring it is printed clearly.
3. Provide your signature to authorize the use of your medical information.
4. Enter your University of Michigan Identification Number (UMID) in the specified field.
5. Indicate the date of the examination that you are concerned about.
6. Record the date of your medical examination in the provided space.
7. The physician, physician’s assistant, or nurse must then complete their section. They should print their name and provide their signature.
8. The healthcare provider will need to respond to four questions regarding your medical condition, marking 'Yes' or 'No' as appropriate.
9. For questions requiring a date, the physician should fill in the month and day as applicable.
10. Finally, the physician, PA, or nurse should include their title and the official stamp of the health care organization for verification.
11. Once all fields are completed, you can save your changes, download the form, print it, or share it as needed.

Complete your Medical Emergency Form online today to ensure your academic needs are met.