The above Medical Information is being collected so that SBC may better address your medical needs and any dietary concerns you may have. This information may be shared among SBC faculty for administrative purposes to support your learning experience. In the event of an emergency medical situation, SBC will disclose this information only to health care providers for your assistance. This information will be stored in a secure and controlled manner.
The collection of this information does not in any way make SBC responsible or liable for monitoring your diet or medical condition, or suggest that SBC has the facilities to address your individual needs. The collection of this information makes it possible for SBC to provide information in emergency situations and to provide you with the most valuable experience possible while studying on our campus.
By submitting this form, you acknowledge that you are 18 years of age or older and you consent to the collection, use, and disclosure of your medical information as outlined above. (if under 18, a parent/gaurdian signature is also required)