Medical Consent

Client Medical Consent

In a EMERGENCY please contact your own GP. The Cumbria Health On Call team (CHOC) are also available out of hours on 111. The Samaritans are available 24 hours a day on 116 123.

SAFA is GDPR compliant. Once the below form is submitted to us, the forms data is encrypted and automatically password protected. Only a team member from SAFA can access the data provided.

    Please input using a keypad or keyboard.

    I, do hereby consent for the designated person at SAFA to offer first aid supplies should it be required. In the event of the designated qualified first aid person not being present, I agree to being transferred to the Accident and Emergency at my local Hospital.

    Digital Signature - Please input using a keypad or keyboard.

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    * by submitting this form you are consenting to the medical agreement outlined above.

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