Get Exploring Joara Foundation Child Emergency Contact And Medical Form

Filling out the Exploring Joara Foundation Child Emergency Contact and Medical Form is essential for ensuring the safety and well-being of your child during program activities. This step-by-step guide provides comprehensive instructions for completing the form online accurately and efficiently.

Follow the steps to complete the form online.

1. Use the ‘Get Form’ button to access the form and open it in your preferred digital document tool.
2. In Section 1, provide the basic contact information for your child, including their last name, first name, middle name, home address, and date of birth. Include at least one telephone number for reliable communication.
3. List emergency contact details for two individuals. For each contact, provide their name, relationship to the child, street address, and multiple telephone numbers.
4. In the child’s physician and dentist/orthodontist section, fill in the names and contact numbers for both healthcare providers.
5. In Section 2, provide insurance information by filling out the insurance carrier, address for claims, group or policy number, policy holder's name and date of birth, the relationship to the child, and the policy holder’s insurance ID number. Remember to attach a photocopy of the policy holder's insurance card.
6. Proceed to Section 3 to disclose any pertinent health information about your child. Answer yes or no to the list of health conditions and allergies, and if applicable, provide descriptions. Include details about any current medications.
7. Indicate the date of the child's last medical check-up, ensuring it is after June 1, 2011, or mark any scheduled future check-ups.
8. Sign and date the form in the designated areas to grant permission for program staff to facilitate necessary treatment in case of medical emergencies and to use any photographs or videos for promotional purposes.
9. Once all sections are completed, review the information for accuracy. Save changes to your document, and you can choose to download, print, or share the completed form as needed.

Complete your documents online today to ensure your child is prepared for their program activities.