Procedures Emergency and health form Student InformationName and Surname: Date of Birth (D/M/Y): DD slash MM slash YYYY Our school is obliged to ensure the safety and health of its students during their time in the school (during performance of education and activities). In case of serious emergency/injury the school will make sure that the injured child is handed over to professional medical services as soon as possible.Does your child have any allergies we should be aware of? YES NO If yes, please explain?Does your child have any other health condition that we should be of? YES NO If yes, please explain?Is your child on any medication treatment that we should be aware of? YES NO If yes, please explain?In case of serious emergency, I authorize school authorities to take any steps necessary to administer or make a decision regarding medical treatments to my child/children YES NO Please provide your child's physician contact details:Physician Name Physician Phone NumberPhysician Health Center Please provide details of your child's health insurance detailsParent Emergency Contact InformationParent Name Parent Phone NumberParent Email CommentsThis field is for validation purposes and should be left unchanged.
