It is very important that Omnitech Institute be informed of any existing illness and or handicaps that a student may have so that in the event of an emergency accurate information can be given to medical officials.

Please answer the questions below very carefully.
Do you have any chronic diseases that exist in active or remission form or have you ever been diagnosed with a disease that could affect you or your future classmates’ functionally in school or that could impair your Educational process? *
Do you have any allergies? *
Do you have high blood pressure? *
Are you currently taking prescription drugs for any medical conditions not mentioned? *
I choose not to disclose any information regarding any existing medical condition(s) that I have to Omnitech Institute. I will take full responsibility for any incident that occurs on Omnitech Institute’s campus. I will not hold Omnitech Institute responsible in any way for any incidents or problems associated with my health.

In case of an emergency contact:

Primary Physician