If you are taking a trip with your child, you should have all of your child’s information printed or written out so it will be available in case of an emergency.
Here are the basics. Fill out this form and keep a copy with both you and your spouse.
Child's name:
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Address
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_____________________________________
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Town or City
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_____________________________________
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Phone
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_____________________________________
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PPS or NI number
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_____________________________________
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Child's doctor at home: |
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Name
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_____________________________________
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Phone
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______________________________________
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Child's doctor away from home: |
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Name
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_____________________________________
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Phone
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_____________________________________
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Child's health insurance: |
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Company name
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____________________________________
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Policy number
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____________________________________
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Phone
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____________________________________
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Emergency contacts: |
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Name
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____________________________________
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Phone
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_____________________________________
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Relationship
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_____________________________________
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Name
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_____________________________________
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Phone
|
_____________________________________
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Relationship
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_____________________________________
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Child's medical history: |
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Preexisting conditions
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_____________________________________
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Allergies
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_____________________________________
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Immunisation history
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_____________________________________
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Comments
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_____________________________________
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_____________________________________
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