Confidential Medical Information Form
The Highlands LLEN VET Cluster will distribute this information to the relevant VET program teacher for use if your child is involved in a medical emergency. All information contained in the form will be stored, used and disclosed in accordance with the requirements of the Privacy Amendment (Private Sector) Act 2000.  Parents are responsible for all medical costs if a student is injured unless the Department of Education is found liable (liability is not automatic). Parents can purchase student accident insurance cover from a commercial insurer if they wish.
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VET program: *
Student’s full name: *
Student’s home school: *
Parent/guardian’s full name: *
Name of person to contact in an emergency: *
Emergency telephone number/s: *
Name of family doctor: *
Address and phone number of family doctor: *
Medicare Number: *
Medical/hospital insurance fund member number::
Ambulance subscriber: *
If yes ambulance membership number:
Please tick if your child suffers any of the following:
Does your child suffer from any allergies?: *
If yes, please list allergies:
Year of last tetanus immunization: (Tetanus immunization is normally given at five years of age (as Triple Antigen or CDT) and at fifteen years of age (as ADT) *
Is your child taking any medicine(s)?: *
If yes, provide the name of medication, dose and describe when and how it is to be taken:
All medication must be given to the teacher-in-charge. All containers must be labeled with your child’s name, the dose to be taken as well as when and how it should be taken. The medications will be kept by the staff and distributed as required. Inform the teacher-in-charge if it is necessary or appropriate for your child to carry their medication (for example, asthma puffers or insulin for diabetes). A child can only carry medication with the knowledge and approval of both the teacher-in-charge and yourself.
Medical consent
In an emergency, where the teacher-in-charge is unable to contact me, I authorise them to:
•      consent to my child receiving any medical or surgical attention deemed necessary by a medical practitioner
•      administer such first-aid as the teacher-in-charge judges to be reasonably necessary.

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