Get Off-campus Event Emergency Information Form - California State ...

Filling out the Off-campus Event Emergency Information Form is crucial for ensuring your safety and access to medical care during an off-campus event. This guide provides a clear, step-by-step approach to complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Press the 'Get Form' button to access the Off-campus Event Emergency Information Form and open it in your preferred editor.
2. Enter the participant's name, including the last name, first name, and middle initial, in the designated fields.
3. Fill in the SID number, home address, telephone number, age, and date of birth.
4. List emergency contact(s) by entering their names, relationships, and phone numbers in the provided sections.
5. Complete the personal physician's section by providing their name, address, and phone number.
6. Indicate any medications you are currently taking and any medications you are allergic to.
7. Specify whether you wear contact lenses or glasses by checking the appropriate boxes.
8. Describe any medical conditions that emergency care providers should be aware of in the provided space.
9. Indicate whether you have health insurance by answering yes or no, and if applicable, provide the name of the insured, insurance company, policy number, and contact information.
10. Provide your consent for the university to release your information to medical professionals by signing and dating the form. If the participant is a minor, a legal guardian must sign.
11. After completing all sections, save your changes. You can then download, print, or share the form as needed.

Complete your Off-campus Event Emergency Information Form online today to ensure your safety during events.