A MORNING CALL

A Morning Call

A MORNING CALL QUESTIONNAIRE

Names of Emergency Contacts
Information important to know about me; OPTIONAL

MedicalDiagnoses/Concerns I have about my health : (Optional)

By signing this document, I do give you permission to contact my “emergency contacts” in the event I cannot be reached. I understand A Morning Call will initiate a “test”call to confirm phone numbers on my behalf before starting the program. I will let my contacts know that A Morning Calling will be reaching out to them to confirm working phone numbers.
I understand that A Morning Call will reach out to me 3 times before calling my emergency contacts.
I acknowledge that A Morning Call is not a medical service and is not liable for any injuries or emergencies sustained if I cannot be reached.