WEST CLERMONT EMERGENCY MEDICAL SCHOOL DISTRICT 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your email address at the top of the form. This ensures that you receive any necessary confirmations.
3. Fill in your child's name, school, and grade. Accurate information is crucial for proper identification.
4. Provide your child's address, date of birth, student ID, and teacher's name to complete their identification details.
5. List parent/guardian names along with their relationship to the student and contact numbers (home, cell, work). This allows for effective communication in emergencies.
6. In the designated section, list individuals authorized to be contacted or pick up your child if needed. Ensure they are over 18 years old.
7. Detail any medical history relevant to emergency treatment, including allergies and medications. This information is vital for healthcare providers.
8. Indicate your preferred doctor and dentist along with their contact numbers for quick access during emergencies.
9. Select a preferred local hospital where your child can be taken if necessary.
10. Choose whether to grant consent for emergency medical treatment by signing in Part 1 or refuse consent in Part 2. Make sure to date your signature.

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