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Medical Information & Release Form - GO Ministries - gomin

Medical Information & Release Form - GO Ministries - gomin 2025

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The document is a medical information and release form for participants of a short-term mission trip to the Dominican Republic organized by GO Ministries, Inc. It includes sections for personal medical history, emergency contact information, and consent for medical treatment in emergencies. Additionally, it contains a liability waiver releasing the organization from claims related to participation in the trip, along with agreements regarding costs and responsibilities during the mission.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information, including your name, address, city, state, and zip code. This ensures that the organization can contact you if necessary.
Fill in your home and work phone numbers. Providing multiple contact options is crucial for emergency situations.
Indicate any medical conditions you may have by checking the relevant boxes. This section is vital for ensuring your safety during the mission trip.
List any medications you are currently taking along with their dosages. This information helps medical personnel provide appropriate care if needed.
In the emergency contact section, provide details of a person who can be reached in case of an emergency. Include their relationship to you and their contact information.
Finally, review the release agreement carefully before signing. Ensure you understand all terms regarding participation and liability.

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Versions	Form popularity	Fillable & printable
2014	4.8 Satisfied (48 Votes)

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How do I write a release form?

Some of the crucial information in a release includes: Name of the parties involved, i.e., releasor and releasee. Detailed information about the project. Explicit information of the permissions granted. Any special considerations, including payment obligations or credit, if any. A space for all parties to sign.

What is a medical record release form?

A medical record release form is a legal document that allows the patient access to their medical record. This form is used by medical organizations to track the medical history of patients and ensure that all information is accurate.

How do I fill out a medical release form?

Begin by specifying your name, the entity authorized to disclose information, and the individuals or entities you authorize to receive it. Indicate the specific information and purpose for which it will be disclosed, add an expiration date or event, and sign and date the form to confirm your consent.

How to fill a medical form?

How to fill out the Filling Out Medical Forms: Essential Guide? Read the instructions thoroughly. Complete your personal information accurately. Double-check for any errors. Sign and date the form. Submit the form as instructed.

What to put on a medical form?

What are the most important details in your medical history? chronic or new symptoms and conditions. past surgeries. family medical history. insurance information. current prescription and over-the counter medicines, supplements, vitamins, and any herbal remedies or complementary medicines you use. medication allergies.