Player Medical Form PDF Details

As an athlete, taking good care of your health is essential for achieving peak performance. Ensuring that all players have up-to-date medical forms on file is the first step in helping prevent injury and illnesses. Having access to a comprehensive player medical form can provide coaches and team officials with important information regarding injuries, allergies, medications and more each season. In this blog post, we’ll take a look at what having an up-to-date player medical form means for athletes today and explain how teams are using them to track physicals, immunizations and other medical information effectively.

QuestionAnswer
Form NamePlayer Medical Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameshockey canada health form, canada hockey sheet, canada hockey player medical form, hockey canada player medical form

Form Preview Example

HOCKEY CANADA

PLAYER MEDICAL INFORMATION SHEET

Name: ____________________________________________________________________________________

Date of birth: Day __________ Month __________ Year __________

Address: __________________________________________________________________________________

Postal Code: _________________________________ Telephone: _________________________________

Provincial Health Number: __________________________________________________________________

Mother’s Name: ____________________________ Father’s Name: ______________________________

Business Telephone Numbers: Mother _____________________ Father ________________________

Person to contact in case of accident or emergency, if parents are not available.

Name: _________________________________________ Telephone: _________________________________

Address: ____________________________________________________________________________________

Doctor’s Name: _________________________________ Telephone: _____________________________

Dentist’s Name: ________________________________ Telephone: _____________________________

Please circle the appropriate response below pertaining to you child

Yes

No

Previous history of concussions

Yes

No

Fainting episodes during exercise

Yes

No

Epileptic

Yes

No

Wears glasses

Yes

No

Are lenses shatterproof?

Yes

No

Wears contact lenses

Yes

No

Wears dental appliance

Yes

No

Hearing problem

Yes

No

Asthma

Yes

No

Trouble breathing during exercise

Yes

No

Heart Condition

Yes

No

Diabetic

Yes

No

Has had an illness lasting more than a week in the past year

Yes

No

Medication

Yes

No

Allergies

 

 

 

 

 

 

 

 

HOCKEY CANADA SAFETY PROGRAM

19

HOCKEY CANADA

Yes

No

Wears a medic alert bracelet or necklace.

Yes

No

Does your child have any health problem that would interfere

 

 

with participation on a hockey team?

Yes

No

Surgery in the last year.

Yes

No

Has been in hospital in the last year.

Yes

No

Has had injuries requiring medical attention in the past year.

Yes

No

Presently injured.

Please give details below if you answered “Yes” to any of the above items.

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

Use separate sheet if necessary

Medications: _____________________________________________________________________________

Allergies: __________________________________________________________________________________

Medical conditions: ______________________________________________________________________

Recent Injuries: ___________________________________________________________________________

Last Tetanus Shot:________________________________________________________________________

Any information not covered above:______________________________________________________

___________________________________________________________________________________________________

Date of last complete physical examination: _____________________________________________

*Any medical condition or injury problem should be checked by your physician before participating in a hockey program.

I understand that it is my responsibility to keep the team management advised of any change in the above information as soon as possible and that in the event no one can be contacted, team management will take my child to hospital/M.D. if deemed necessary.

I hereby authorize the physician and nursing staff to undertake examination investigation and necessary treatment of my child.

I also authorize release of information to appropriate people (coach, physician) as deemed necessary.

Date: ____________ Signature of Parent or Guardian: __________________

HOCKEY CANADA SAFETY PROGRAM

20

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How you can fill in canada hockey sheet part 1

2. Once your current task is complete, take the next step – fill out all of these fields - Address, Doctors Name Telephone, Dentists Name Telephone, Please circle the appropriate, Yes No Yes No Yes No Yes No Yes No, and Previous history of concussions with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Guidelines on how to fill in canada hockey sheet stage 2

It's easy to make a mistake while completing your Please circle the appropriate, hence make sure that you take another look prior to deciding to send it in.

3. Your next stage is usually hassle-free - complete all the empty fields in Yes No Yes No Yes No Yes No Yes No, Yes No, Previous history of concussions, Allergies, and HOCKEY CANADA SAFETY PROGRAM to complete this part.

Tips to fill in canada hockey sheet stage 3

4. The next part requires your involvement in the following places: Yes No Yes No, Yes No Yes No Yes No, Yes No, Wears a medic alert bracelet or, Presently injured, Please give details below if you, Use separate sheet if necessary, Medications, and Allergies. Be sure that you provide all requested information to go further.

Step # 4 in filling in canada hockey sheet

5. To finish your form, this last area incorporates several extra blanks. Filling in Medical conditions, Recent Injuries, Last Tetanus Shot, Any information not covered above, Date of last complete physical, Any medical condition or injury, before participating in a hockey, I understand that it is my, of any change in the above, and I hereby authorize the physician will certainly finalize the process and you will be done very quickly!

How to prepare canada hockey sheet step 5

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