2021 Uintah Marching Band Medical Release and Permission Form
IMPORTANT! PLEASE READ: This form must be submitted before Band Camp. This Medical / Health form will be kept with the medical kit at all times in case of a medical emergency involving your student. Make sure ALL blanks are completed. If an item does not apply to your student, please put NA in the blank to insure accurate information. Incomplete forms can not be accepted.
Mr. Gibson is a Certified Advanced Emergency Medical Technician for the State of Utah. He will personally see to all medical needs prior to seeking advanced medical help. If emergency care or a doctor are needed the student will be transported to definitive care as quickly as possible and the parents will be notified.
Since medical information is considered privileged information rest assured that this information will be kept private and used only as HIPPA allows. For the safety of your child the more complete this information is the better we can see to his/her care. Not all questions are marked as required to submit the form, but the more you can fill out the better. Be as complete as you can, but if you just don't know leave it blank if it is not required.