Emergency Information Sheet

2010-2011

What is the Emergency Information Sheet?

• Every student must complete an Emergency Information Sheet (EIS). They are submitted online and can be collected at the orientation session, or mailed to University Housing. – Emergency Information Sheets that are submitted

online will be signed by the student at check-in.– RAs will hand out blank sheets at floor meetings to

those who have not completed one and then return them to the secretary.

• The Emergency Information Sheet provides staff members with the necessary contact information in the event of harmful accident, illness or injury to the student.

• Information on the Emergency Information Sheet is confidential and should only be used for its intended purposes.

Emergency Information Sheet

• The Emergency Information Sheet contains general information such as:– Name– Home Address– Cell Phone Number– Date of Birth– Parent Contact Information– Two (2) Emergency Contacts – Student medical conditions (if any)– Request for Sharp’s container if

needed

Important Signature

• The student must sign and date the Emergency Information Sheet.

• The student’s signature signifies they understand and agree to the information appearing on the card being provided to a parent, legal guardian, medical personnel or University Staff member in the event of an emergency.

EIS Process

• Prior to move in the Emergency Information Sheets (EIS) will be printed by Central Office staff and distributed to the hall secretary in time for the secretary to set up student files.

• Hall secretary should enter the EIS into Web Check In when received.

• Hall secretaries will review student files to verify each student file has a completed Emergency Information Sheet prior to assembling the key/fob packet.– Student will sign form when they return check in paperwork

to front desk

• If the student has not completed an EIS form prior to the key/fob packet assembly the secretary will mark the key/fob packet with a round colored label and attached a folded blank EIS form to the key/fob packet along with the key card.

• It is the secretary’s responsibility to follow up with RA staff and CRE to ensure the Emergency Information Sheet is received and signed by the 5th day of classes.

Sharps containers

• If the Emergency Information Sheet indicates the student required a Sharps container, one should be issued at check-in.

• The student should be instructed to return the container to the front desk once it is filled in order to obtain a new one.

• It is the responsibility of the secretary to keep one or two extra Sharps containers in the cabinet at all times.

• When used Sharps containers are returned, the secretary will contact Environmental Health and Safety at 575-5448 to request a pick-up and replacement of Sharps containers.