ER Connect is your way of getting us to your family without delay if you are ever in an accident! Providing us with your name, number and 2 emergency contacts will better our response time as well and provide your family with the assistance they need!
The emergency contact information you provide to the contractor/utility/hall/apprenticeship/medical staff is protected by HIPPA and privacy laws and therefore will not be shared with anyone.
We would like you to know that we as well take your privacy very seriously. Our website has a disclaimer and privacy notice.
ALL INFORMATION WILL BE KEPT CONFIDENTIAL!!!
YOUR INFORMATION WILL NEVER BE USED FOR ANYTHING ELSE! WE WILL NEVER SOLICIT OR SEND YOU ANYTHING!!!
*The information you provide will only be used by the Board of Directors in the event you are involved in an accident. That information will not be shared. One of the Board members will get in touch with your Emergency Contacts to find out where she is in need of assistance, that assistance will then be arranged thru our very private LineLife Foundation Hearts and Hands Volunteers. Most times our volunteers visit families in the waiting room and do not go into the patient’s room unless invited. They also do not speak about the accident. There are times when our care packages are left with hospital staff to be given to the family with no contact made at all.
By completing this form, I hereby give LineLife Foundation permission to contact the listed Emergency Contacts to provide assistance pursuant to their Mission Statement in the event of an incident. I am aware that completing this form is voluntary.