MEMBER’S NOTIFICATION LIST

This is a notification list of people you want MFES to contact in the event of an emergency situation in which my loved ones enrolled in MFES emergency program are unable to communicate with medical and law enforcement personnel. By signing below you give MFES authorization to contact up to three people listed below. You should contact each one of the people listed below and inform them that you have joined MFES.

MEMBER’S NOTIFICATION LIST

Member’s Name
Contact # 1 Name