Child’s Emergency Contact and Medical Information Form

Emergency Medical Contact Information

All the childcare providers and schools should maintain child’s emergency contact and medical information form. This information form is having a great significance in event of some emergency because this form contains complete medical and emergency contact information about the particular child. Whenever any emergency occurs to a child, this form plays a vital role for first hand information and help. This is an important document that ensures appropriate and prompt care for the child in case of any emergency. This document is a useful tool for parents as well as for school management that can be utilized in unseen and unexpected events.

Child’s emergency contact and medical information form mainly has three sections of information. First section is related to child’s basic information, second section is related to emergency contact information and third section is all about medical information. The first section that is related to child’s basic information contains information about child name, date of birth, gender, parent/guardian name, home phone, work phone, complete address, city etc. The second portion that is emergency contacts is all about primary emergency contact and contact number, secondary contact, home phone, work phone, home address and city etc. The third and last section is all about medical information and it includes hospital/clinic preference, physician’s name and contact number, insurance company and policy number. This portion also contains an undertaking by the parent or guardian that says that in case of any emergency, the school management can carry out necessary measures according to information given in child’s emergency contact and medical information form, if the parent or guardian cannot be reached in time. This form can be served as contact form or emergency contact information also. The given form cal also be used as medical release form, information release form and medical authorization form.

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Child's emergency contact and medical information form

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