Back to Results
First PageMeta Content
Olympic Games / Healthy Athletes / Special Olympics / Down syndrome / Syndromes


MEDICAL RELEASE FORM SOAZ USE ONLY:  New Athlete  Recorded in GMS  Initial _____
Add to Reading List

Document Date: 2014-09-18 18:48:13

Open Document

File Size: 258,04 KB

Share Result on Facebook

City

Phoenix / /

Company

Health/Accident Insurance Company / /

Facility

Clinic Name / /

IndustryTerm

health services / /

MedicalCondition

Joint Problem Autism Chest Pain Seizures/Epilepsy / Heart Disease/Heart Defect/High Blood Pressure Allergies / Constant Supervision Allergies / Loss/Hearing Aid Allergies / Stroke / tetanus / Serious Head Injury Sickle Cell Trait / butterfly stroke / Blindness / Down Syndrome / FOR ALL AREAS Yes No Yes No Allergies / /

MedicalTreatment

immunization / Immunizations / Major Surgery / physical therapy / /

Organization

Foundation for the Benefit of Citizens / State Office / Special Olympics State Office / /

Person

Etiology / Injury Sickle / /

/

Position

adult athlete / OFFICIAL / PARENT/GUARDIAN OR ADULT ATHLETE / Athlete / Major / PARENT/CAREGIVER/ADULT ATHLETE / Serious Head / Head Coach / athlete and physician / Apt# Athlete / licensed physician / DEMOGRAPHICS Athlete / /

ProvinceOrState

Alaska / Arizona / /

PublishedMedium

Guardian / /

SportsEvent

Olympics / /

SportsGame

swimming / skiing / gymnastics / football / soccer / judo / high jump / snowboarding / /

Technology

x-ray / /

URL

www.SOAZ.org / /

SocialTag