Georgia Emergency Information Form

State:
Multi-State
Control #:
US-1135BG
Format:
Word; 
Rich Text
Instant download

Description

The information provided on this form should be used in an emergency to notify specified individual(s) of a serious illness, injury, or incident. This information should remain confidential.
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FAQ

An emergency contact is the first person medical personnel will get in touch with in an emergency, but your emergency contact may not have the legal authority to act on your behalf unless you explicitly provide that power.

The GEMA-HS Public Assistance Department staff administers the Federal Emergency Management Agency (FEMA) Public Assistance (PA) Grant Program.

Emergency information forms (EIFs) provide essential medical information for CMC during emergencies; however, they are not widely used. We sought to identify factors related to optimal care for CMC to inform development of EIFs for CMC.

Georgia Emergency Management and Homeland Security Agency.

An "in case of emergency" form can be an important tool used to identify contacts and medical providers for someone who is suffering a health emergency. You can place an "in case of emergency" form on your refrigerator or in your vehicle to assist first responders during a call.

Who is GEMA/HS? We are the state's preparedness, response, and recovery agency. We work with public and private sector organizations to prevent and respond to natural and man-made emergencies.

Georgia law directs GEMA/HS to provide school safety training and technical assistance to the education, emergency management and public safety communities of Georgia.

AdvertisementYour name, age and sex.Your address.Your medication names, doses and schedules.Your medical equipment.Your chronic medical conditions, such as epilepsy.Medical consent form.Aspects of your health history that could be helpful to emergency medical responders, including allergies and immunization record.More items...

The Georgia Emergency Management and Homeland Security Agency coordinates the state's preparedness, response and recovery efforts to disasters. As part of the Office of the Governor, GEMA/HS operates under the authority of the Emergency Management Act of 1981.

Emergency contact forms should be completed as part of an employee's on-boarding paperwork. The emergency contact form should request that the employee provide the name, home phone number, cell phone number, and email address of at least two people to contact in the event of an emergency.

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Georgia Emergency Information Form