Student Emergency Contact Form (Page 2 of 2) in pdf

Student Emergency Contact Form Page 2

CONSENT TO MEDICAL ATTENTION IN THE EVENT OF ACCIDENT OR ILLNESS

Any accident or illness problems will be referred to the Royal Melbourne Hospital,

Parkville.

Every attempt will be made to contact your emergency contacts you have provided as

above.

For more serious cases an ambulance will always be called.

In the event of any accident or illness, I authorise the Royal Children’s Hospital to see

such medical or surgical treatment which may be deemed necessary should I be unable

to make decisions.

Student Signature: _____________________________________________________________________

Date:

_____________________________________________________________________

Student Emergency Contact Form Page 2