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  • Student Waiver EAST AVE NEW

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    troigarnica09
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    The document is a waiver form for students from Our Lady of Fatima University conducting their Related Learning Experience at East Avenue Medical Center during the COVID-19 pandemic. The waiver releases the medical center, nursing staff, doctors, and other hospital employees from liability for any illness the student may incur during their learning experience at the hospital during the pandemic. The student and their parent or guardian must sign the waiver acknowledging they understand and agree to its terms.

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    Student-Waiver-EAST-AVE-NEW

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    The document is a waiver form for students from Our Lady of Fatima University conducting their Related Learning Experience at East Avenue Medical Center during the COVID-19 pandemic. The waiver releases the medical center, nursing staff, doctors, and other hospital employees from liability for any illness the student may incur during their learning experience at the hospital during the pandemic. The student and their parent or guardian must sign the waiver acknowledging they understand and agree to its terms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    8 views1 page

    Student Waiver EAST AVE NEW

    Uploaded by

    troigarnica09
    The document is a waiver form for students from Our Lady of Fatima University conducting their Related Learning Experience at East Avenue Medical Center during the COVID-19 pandemic. The waiver releases the medical center, nursing staff, doctors, and other hospital employees from liability for any illness the student may incur during their learning experience at the hospital during the pandemic. The student and their parent or guardian must sign the waiver acknowledging they understand and agree to its terms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    EAST AVENUE MEDICAL CENTER

    NURSING SERVICE DIVISION


    East Avenue, Quezon City
    Trunk Line-928-06-11 loc. 203/252
    Email address:nursingoffice15@yahoo.com
    ______________________________________________________________________________

    W A I V E R

    I, _______________________________________, age ____________ and residing at

    ________________________________________________ renounce and waive any

    claim against the East Avenue Medical Center, nursing personnel, physicians, and other

    hospital staff from responsibility and liability for any consequence, directly or indirectly

    due to illness incurred during Related Learning Experience (RLE) at the time of COVID-

    19 Pandemic.

    _____________________________________
    Student’s Signature Over Printed Name

    OUR LADY OF FATIMA UNIVERSITY - VAL


    Name of the College/University

    WITNESS:

    _______________________________________
    Signature of Parent/Guardian Over Printed Name

    ATTESTED:

    Signature of Clinical Instructor Over Printed Name

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