Emergency Medical Treatment Letter
Dear Parent / Guardian,
In the event of any minor accident occurring at school, we are able to provide competent First
Aid for any injury sustained.
On the rare occasion when an accident of a more serious nature occurs, and when, in our
opinion, assessment and/or treatment of the injury requires attendance at a clinic, every effort
is made to contact you or the “emergency contact person” named in our files, in order that
you may take your child to the doctor immediately.
If we are unable to contact you, and speed is necessary to deal with the emergency, we have
an agreement for treatment with the doctors at the Clinica El Avila. In order to take your child
there, we MUST HAVE YOUR WRITTEN PERMISSION. A representative of the school
would then accompany your child to the clinic. We will only do this in the event of a very
serious or life-threatening occurrence. We would of course continue to make every effort to
contact you.
Yours Sincerely,
Edwina Wilkinson
School nurse
Office number 2662270 (EXT 204)
Mobile: 0412 2344 934
E-mail:
ewilkinson@tbscaracas.com
Emergency Medical Treatment Form
Child’s names: ______________________________________________________
Are you affiliated to any ambulance service? Name: ___________________________
Childs affiliation number._______________________________________________
In the event of any accident or illness which, in the opinion of the Head of School, or his
representative(s), requires assessment, and \ or treatment by a doctor:

I DO GIVE PERMISSION for my child to be taken to the Clinica El Avila
o Name of doctor _______________________________

I DO NOT GIVE PERMISSION for my child to be taken to the Clinica El Avila.
I prefer my child to be taken to _____________________________________
* Please delete the sentence that is not applicable
Name: _______________________________________________________________
Signature
___________________________________________________________
Date: ______________________________________________________________________