This form authorizes treatment for athletes and students of a college and university and provides important information to hospitals, clinics and attending physicians. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.New Orleans Louisiana Identificación de Seguro para Colegio o Universidad y Autorización - Identification of Insurance for College or University and Authorization
State:
Multi-State
City:
New Orleans
Control #:
US-02397BG
Format:
Word
Instant download
Description
Free preview
