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Medical and emergency information form

Health, allergies, emergency contacts and consent

For WatuFlex clients · Web page and Word file

Student name
Class
Blood group (if known)
Allergies
Chronic conditions and medication
Family doctor / clinic

Emergency contacts

NameRelationshipPhone

I consent to the school arranging emergency medical treatment for my child if I cannot be reached in time. The school will contact me as soon as possible.

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