EMERGENCY MEDICAL AUTHORIZATION FORM

This form may be used by child's daycare provider or parents of children attending school, camp, or parents of a mother or father in the care of a health care provider, etc. where a signed authorization to provide emergency medical treatment is needed.

On the first day of school, or when a student enrolls during the school year, each student is required to turn in emergency medical authorization forms. It is important to have these forms properly completed and returned to school. In the event a student must be transported to the hospital for treatment, this form enables the hospital personnel to perform emergency treatment immediately rather than having to wait for parents to be contacted.

1. We have provided an authorization form for you to print and use.