Overview

The Refusal of Medical Aid form documents situations in which an individual involved in a production declines medical assistance after an incident, injury, or safety-related event occurring during production activity.

Proper documentation of medical incidents is important because productions have a responsibility to maintain clear records related to on-set safety, injuries, and incident response. Recording a refusal of medical aid helps establish accurate documentation of the situation while reinforcing the importance of communication, accountability, and safety procedures within production environments.

Paperwork

Instructions

If a person is injured or experiences a medical emergency during the workday, the standard procedure to prioritize getting the person medical attention. There are circumstances, however, where an individual may choose to not get medical aid.

This form should only be used after an injury, illness, or medical incident in which an individual declines first aid, medical treatment, or transport after assistance has been offered. The form exists to document that the individual voluntarily refused care and understood the risks associated with that decision.

The form should be completed as soon as possible following the incident. Producers or set safety personnel should ensure that all sections are filled out clearly and accurately, including:

• the date and location of the incident;
• the nature of the illness or injury;
• the medical aid or treatment that was offered;
• the reason the individual declined assistance, if provided.

The injured or ill individual should personally complete and sign the form whenever feasible. A witness should also sign the form.

Signing the form documents that care was declined at the time of the incident and that the individual has released the production from any liability resulting from the refusal of medical aid. Signing the form does not prevent the individual from later seeking medical care.

This form should be retained with the production’s safety paperwork and incident documentation. If the situation appears serious or life-threatening, students should immediately contact emergency services and notify faculty, even if the individual initially refuses assistance.