Common use of Emergency Coverage Clause in Contracts

Emergency Coverage. ▇▇. ▇▇▇▇▇▇ has a professional duty to make arrangements for your continuing care in the event ▇▇. ▇▇▇▇▇▇ becomes unavailable due to incapacitating illness or death. Accordingly, should ▇▇. ▇▇▇▇▇▇ become unavailable due to incapacitating illness or death, a designated professional with credentials at least equivalent to those of ▇▇. ▇▇▇▇▇▇ will notify you. At your request, that professional will provide a referral for further care. The professional will also inform you where your records will be stored and what you will need to do if you wish to access them. By signing permission line number one (1) below, you give ▇▇. ▇▇▇▇▇▇ permission to provide your name, address, and phone number, information about your case and access to your records to the professional who will be responding should ▇▇. ▇▇▇▇▇▇ become unavailable due to incapacitating illness or death. Access to information about your case and to your records would be very helpful to this professional in referring you to other appropriate health care providers who may be able to provide you with continuing care in the event ▇▇. ▇▇▇▇▇▇ cannot continue to provide you with care. This professional will keep confidential all information obtained about you from ▇▇. ▇▇▇▇▇▇, obtained from you in speaking with you and obtained in reviewing your records just as ▇▇. ▇▇▇▇▇▇ has kept that information confidential. If you do not want ▇▇. ▇▇▇▇▇▇ to allow this professional to have any information about you other than your name, address, and telephone number, so you can be notified of ▇▇. ▇▇▇▇▇▇’▇ incapacitating illness or death, or to have any access to your records, please so confirm by signing permission line numbered two (2) below.