Emergency Medical Treatment. I grant the Releasees permission to authorize emergency medical treatment as they deem appropriate, and agree that such action by the Releasees shall be subject to the terms of this Agreement. I understand and agree that the Releasees assume no responsibility for any injury or damage that might result from such emergency medical treatment.
Emergency Medical Treatment. The Parents authorise the Head to consent on their behalf to the Pupil receiving emergency medical treatment where certified by an appropriately qualified person as necessary for the Pupil's welfare and if the Parents cannot be contacted in time.
Emergency Medical Treatment. In the event of an emergency, the undersigned hereby give(s) permission to transport the Participant to a hospital for emergency medical or surgical treatment. The undersigned wish(es) to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, if the undersigned cannot be reached at the above numbers, contact: Name & relationship: Phone: ( )
Emergency Medical Treatment. Permission is hereby granted for Participant to receive any and all emergency medical/dental treatment and/or first aid, including authorizing any medical treatment facility/hospital to administer emergency treatment for any illness, injury or accident resulting from participation in the Program.
Emergency Medical Treatment. In the event of an emergency, I give permission to transport my child to a hospital for emergency medical treatment. I wish to be advised prior to any further treatment by a doctor or hospital. In the event of an emergency, if you are unable to reach me at the above numbers, contact: at . (Name) (Phone Number) MEDICAL INFORMATION: Medication my child is taking at present: Allergies: Family Health Plan Carrier Number: Family Doctor: Phone Number: As a parent or guardian, I agree to all of the above stated considerations and conditions. Signature: Date:
Emergency Medical Treatment. (with or without admission): All medical expenses from a non-network provider in relation to emergency medical treatment will be paid as if the insured had been treated at a network hospital.
Emergency Medical Treatment. The Plan Bupa Group policy provides emergency medical treatment outside of the Preferred Provider Network in those cases where the emergency treatment is required to avoid loss of life or limb. Covered charges related to an emergency admission to a non-network provider will be paid up to twenty-five thousand dollars ($25,000) with the normal plan deductible and coinsurance (if applicable). The Insured will be responsible for thirty percent (30%) of all covered medical and hospital charges that exceed the benefit of twenty-five thousand dollars ($25,000) on services performed outside the Preferred Provider Network.
Emergency Medical Treatment. In the event of an emergency, I give permission to transport my child to a hospital for medical treatment. I wish to be advised prior to any further treatment by a doctor or hospital. In the event of any emergency, if you are unable to reach me at the above numbers, contact Name/Relation Emergency Phone Number
Emergency Medical Treatment. The Parents authorise the School Headteacher to consent on their behalf to the Child receiving emergency medical treatment including blood transfusions within the United Kingdom, general anaesthetic and operations performed by the National Health Service or at a private hospital and where certified by an appropriately qualified person as necessary for the Child's welfare, and if the Parents cannot be contacted in time or it is not practicable to contact the Parents.
Emergency Medical Treatment. Should I become injured or ill during my Volunteer activities, I hereby xxxxx Xxxxxxx University full authority to obtain emergency medical services for me at their discretion, or if I am unable to; and I accept responsibility for any related costs thereof, and release the University and their related staff, representatives or host organizations from liability for such decisions. Confidentiality: I acknowledge, that during my voluntary services or participation, I might have access to, or be exposed to confidential information of Stetson University which may include, but not limited to; social security numbers, addresses, telephone numbers, files, correspondence, health or personal information, as well as conversations, electronic records, emails, data bases and recordings. I acknowledge that disclosure of such information could cause irreparable harm or damage to Stetson University, its employees and/or students. I therefore agree that I shall keep confidential and not disclose any information acquired from Stetson University, its staff, students, agents, or representatives in connection with this agreement, services, or participation. I acknowledge and agree that my obligation to maintain confidentiality does not expire and remains in effect even after my agreement for services has expired.
