Get Emergency Contact / Parental Consent Form - Bartos Child And Family ...

This guide provides detailed, step-by-step instructions for completing the Emergency Contact / Parental Consent Form for Bartos Child And Family online. Following these instructions will help ensure that all necessary information is accurately entered to facilitate the care of your child.

Follow the steps to properly complete the form online.

1. Press the ‘Get Form’ button to access the Emergency Contact / Parental Consent Form. This will enable you to download and open the document for editing.
2. Begin by entering your child's name and birthdate. This information is critical to identify the child the form pertains to.
3. Fill in the child's residential address accurately to ensure proper verification and emergency contact.
4. Complete the section for the mother’s name or legal guardian, followed by their home telephone number and cell phone number. Make sure to include the business name and business telephone number if applicable.
5. Next, provide the father’s name or legal guardian, along with their contact information. Similar to the previous step, include all relevant phone numbers and business details.
6. List the emergency contact person(s). Include their names, and any persons who may be authorized to release the child. It is important to include reliable contacts.
7. Provide the address and telephone number of the child's medical care provider. This should include their contact information when the child is in care.
8. Indicate any allergies, including medication reactions, special disabilities, or medical conditions. This section is essential for ensuring the child's safety.
9. Detail any medical or dietary information necessary in an emergency situation. Clear information can help caregivers respond effectively.
10. If applicable, indicate whether your child has an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP). This is relevant for their educational and support needs.
11. Complete the section on health insurance coverage or medical assistance benefits, including the required policy number.
12. For each item listed, indicate your consent by signing next to obtaining emergency medical care, administration of minor first-aid procedures, and other activities such as swimming and transportation by the facility.
13. Finally, provide your signature as the parent or guardian along with the date to verify the accuracy of the information provided. Make sure to double-check all entries for clarity and correctness.

Complete your Emergency Contact / Parental Consent Form online today to ensure your child's safety and proper care.