First Aid Form

If non-emergency medical situation (Level 1) occurs please fill out the following form. Either Danny, Mischa, or Stacey will reach out to you by texting or messaging shortly. If you do not receive a response within 15 minutes, please message the phone hierarchy directly.

Please note, the descriptor text for "Delegate Nation" is wrong. Please follow these instructions instead:

Please put exactly as it is found on their placard: e.g. Trinidad and Tobago; Kamala Harris, D (California); Wall Street Journal (United States); Dr. Theodorus van Kooten

Chair Information
Name *
As appears on your credentials.
Delegate Information
As written on their placard or credentials. For bilingual committees please input in English. For Senate, please omit party affiliation and state.
What is the situation? Do you need first aid supplies (band-aid, gauze, etc.)