Emergency Forms

  • Every student MUST have an emergency form filed in the Health Office. To keep information current, emergency forms are issued to all students each school year. Please contact your child’s school nurse in the event that any of the information changes throughout the year. CORRECT information provided on this form is vital especially in an emergency situation. PLEASE FILL OUT THE EMERGENCY FORM COMPLETELY! It is imperative that the following information be provided:
    • Phone Numbers where parents/guardians can be reached at home, at work, or even when out running errands. Please include all cell phone and/or beeper numbers when available. Please update this information as necessary.
    • Emergency Contacts: Please provide names and phone numbers of persons who are WILLING and ABLE to transport, care for, and assume responsibility for your child in case of illness or injury. This is a serious undertaking and should be arranged by mutual consent. Please be sure that the designated persons are LOCAL AND AVAILABLE during the school day.
    • Medical Conditions: Please provide information regarding medical conditions/chronic illness/diseases, all medications taken (at home and at school), all allergies, including medications, insect stings, foods, and environment. In an emergency situation, IT IS IMPERATIVE THAT THIS INFORMATION BE COMPLETE, DETAILED, AND ACCURATE. If 911 needs to be called, a copy of this information will be sent to the hospital with the EMS personnel.
    • Parent/Guardian Signatures: The parent/guardian’s signature is required on the emergency form. This signature on the emergency form allows emergency personnel to transport your child to the nearest medical facility in the event of an emergency and you or an emergency contact cannot be reached.

Nurse's Documents