Permission for medical treatment
IntroMost martial art schools will require a student to sign a permission for medical treatment form. This gives qualified personnel permission to perform emergency treatment as necessary.
Sample permission for medical treatment formI, __, hereby give my permission, consent, and authorization for any medical treatment deemed necessary by a hospital or physician. I appoint ___ my lawful agent with power to authorize and consent to the administration of medical treatment during the aforementioned training or competition.
Home phone:In the case of such accident or illness, I give permission for medical treatment to be given to me as deemed appropriate. I will assume responsibility for any medical treatment as deemed appropriate. I will assume responsibility for any medical bills incurred on my behalf.
Health insurance carrier:
Other emergency contacts:
List all allergies, restrictions or health exceptions: