Release for Medical Treatment. Employees who have been injured on the job and who have returned to work and are required to take medical treatment which is paid for by Workers' Compensation to treat their industrial injury during working hours, shall be paid in accordance with Part A, Section 12.4. To qualify for payment for this lost work time, the employees must report to the appropriate Division office immediately upon release from their doctor's office, unless excused, and submit their Medical Service Order signed by their doctor.
Release for Medical Treatment. I authorize the College to receive and use the medical information I have provided for the purpose of determining whether, and to what degree, any medical condition(s) or other limitation(s) may impact my ability to participate, or continue to participate, in the College Study Abroad Program. I further authorize the College to receive and to use the medical information for the purpose or determining what actions, if any, may be required to be taken in case a medical emergency exists with respect to my participation in the College Study Abroad Program. In the event of any illness or injury to me if I am unable to grant consent for treatment, I authorize and grant permission to any official representative of the Xxxxxx College program to secure medical treatment (including but not limited to surgery and the administration of an anesthetic), on my behalf, to notify my emergency contact, and to execute written or oral consents to medical action as may be required. I wish to participate in the study abroad program indicated in my letter of acceptance from Xxxxxx College. I have read and I understand the terms of this Acceptance and Release Agreement as stated above, and I agree to be bound by these terms and the terms of the acceptance letter and the Conditions of Participation. It is my express intent that this Agreement shall also bind my family, estate, heirs, administrators, personal representatives and assigns. I state that I am at least eighteen years of age and fully competent to sign this Acceptance and Release Agreement and that I have signed this agreement as my own free act. Student Name Printed Date Student Signature Signed at (city and state) As the parent or legal guardian of the participant whose signature appears above, I have read and understood the terms of this Acceptance and Release Agreement and agree to be bound by these terms and the terms of the acceptance letter and Conditions of Participation, and have given my child or xxxx permission to participate in the study abroad program indicated in the letter of acceptance from Xxxxxx College. Parent or Legal Guardian Name Printed Date Parent or Legal Guardian Signature Signed at (city and state)
Release for Medical Treatment. I authorize the College to receive and use the medical information I have provided for the purpose of determining whether, and to what degree, any medical condition(s) or other limitation(s) may impact my ability to participate, or continue to participate, in the College Study Abroad Program. I further authorize the College to receive and to use the medical information for the purpose or determining what actions, if any, may be required to be taken in case a medical emergency exists with respect to my participation in the College Study Abroad Program.
Release for Medical Treatment. By signing this Agreement, Student gives permission to the Academy to call upon a physician and/or refer Student to a physician for medical assistance in the event of sudden illness or accident. If Student is under 18 years of age, a parent or guardian must give permission to the Academy to call upon a physician and/or refer a physician for medical assistance in the event of sudden illness or accident. :
