• ATHLETE REGISTRATION FORM

  • ATHLETE INFORMATION

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  • Parent / Guardian Information (required if athlete is a minor or otherwise has a legal guardian)

  • Emergency Contact Information

  • Physician & Insurance Information

  • Athlete Medical Form HEALTH HISTORY

    (To be completed by the athlete or parent/guardian/caregiver and brought to exam)

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  • SPORTS PARTICIPATION

  • SURGERIES, INFECTIONS, VACCINES

  • EPILEPSY AND/OR SEIZURE HISTORY

  • MENTAL HEALTH

  • FAMILY HISTORY

  • Athlete Medical Form HEALTH HISTORY

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  • Should be Empty: