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1. Parties: Identifies the parent(s)/legal guardian(s) granting authorization and the babysitter receiving it
2. Background: Brief context explaining the purpose of the medical release form and the caregiving arrangement
3. Definitions: Defines key terms used in the document such as 'Medical Emergency', 'Authorization', 'Medical Treatment'
4. Child's Information: Full details of the child including full name, date of birth, and any identifying information
5. Medical Authorization Grant: Explicit authorization for the babysitter to seek medical treatment in emergencies
6. Emergency Contacts: Prioritized list of emergency contacts including parents/guardians and backup contacts
7. Medical Information: Child's current medical conditions, allergies, medications, and healthcare providers
8. Emergency Procedures: Step-by-step procedures for the babysitter to follow in case of medical emergencies
9. Liability and Indemnification: Statements regarding the scope of babysitter's liability and indemnification provisions
10. Duration and Termination: Period for which the authorization is valid and how it can be terminated
11. Execution: Signature blocks for all parties and witnessing requirements
1. Insurance Information: Details of relevant health insurance - optional if covered in separate documentation
2. Special Care Instructions: Detailed instructions for specific medical conditions - only needed if child has special medical needs
3. Medical History: Detailed medical history - optional unless child has complex medical needs
4. Transportation Authorization: Permission for babysitter to transport child for medical care - optional based on arrangement
5. Preferred Medical Facilities: List of preferred hospitals/medical facilities - optional but recommended
6. Religious Restrictions: Any religious restrictions regarding medical treatment - only if applicable
7. Cost Responsibilities: Details about who bears medical costs - optional if covered in main babysitting agreement
1. Schedule A - Medical History Form: Detailed form containing child's complete medical history, vaccinations, and past procedures
2. Schedule B - Emergency Contact List: Comprehensive list of all emergency contacts with multiple contact methods
3. Schedule C - Medical Insurance Details: Copy of insurance card and detailed coverage information
4. Schedule D - Medication Schedule: Detailed schedule of any regular medications, including dosage and timing
5. Appendix 1 - Emergency Authorization Card: Portable card containing key emergency information and authorizations
6. Appendix 2 - Local Emergency Services Information: List of local emergency numbers, nearest hospitals, and emergency procedures
Medical Emergency
Medical Treatment
Parent/Legal Guardian
Child
Emergency Contact
Healthcare Provider
Medical Facility
Authorization Period
Reasonable Care
First Aid
Emergency Services
Medical Consent
Pre-existing Condition
Prescription Medication
Medicare
Private Health Insurance
Non-prescription Medication
Treatment Costs
Urgent Care
Medical History
Known Allergies
Emergency Transportation
Healthcare Instructions
Confidential Information
Medical Emergency
Liability and Indemnification
Confidentiality
Term and Termination
Emergency Contact
Medical Information
Insurance and Costs
Transportation Authorization
First Aid and Emergency Response
Privacy and Data Protection
Healthcare Provider Access
Child Safety
Force Majeure
Governing Law
Severability
Entire Agreement
Amendment and Modification
Witness and Execution
Childcare Services
Healthcare
Family Services
Domestic Services
Education
Social Services
Insurance
Legal Services
Legal
Compliance
Risk Management
Human Resources
Child Safety
Family Services
Healthcare Administration
Document Management
Client Services
Childcare Provider
Babysitter
Nanny
Au Pair
Family Day Care Provider
Legal Counsel
Compliance Officer
Risk Manager
Insurance Administrator
Human Resources Manager
Child Safety Officer
Family Services Coordinator
Healthcare Administrator
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