Item Number: 41293
Medical Emergency Release Form
Prepare for accidents and injuries with this self-seal form!
Employees voluntarily fill out this medical release, seal it themselves and submit it to Human Resources. Spaces are provided to record medical conditions, allergies, prescriptions, primary care physician and emergency contact information. The self-seal protects private medical information until it is needed by medical responders in the event of an emergency.
Medical information is confidential and must be filed separately from other personnel records as required by federal record keeping laws. Use Amsterdam's Confidential Medical Information File (see item #
30242).
Product Size: 8 1/2" x 11" Flat, Peel-and-Seal Tape Sides
Click here to view a sample of the Medical Emergency Release Form.