SETTLERS RETIREMENT VILLAGES

Emergency Medical Information Form

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It is strongly recommended that each resident completes this form, and it/they are kept in a prominent place in your unit where it is easily accessible in an emergency.

In terms of the POPI Act the information required in this form is of a personal nature, not relevant to the Body Corporate. Therefore this form, when submitted, is only forwarded to the email address supplied in the form. 

Emergency Medical Information

It is recommended that you keep a copy of this form in a prominent pace where it can be easily found in case of an emergency.

Note: One form should be completed PER OCCUPANT

A printable copy of your form will be emailed to you after this form is submitted.

A: OWNER/TENANT



B: MEDICAL INFORMATION

If you have a Living Will, it is suggested that you attach it to this form when you print it.



C: Next of kin not living with you


A printable copy of your notification will be emailed to you after this form is submitted.

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