NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS

WOMEN’S GOLF NATIONAL CHAMPIONSHIP

Medical Form

Forward this form to your head athletic trainer. Please return the completed form via email to the athletic trainer contact listed at the bottom of this document or bring it to team check-in on May 15th.

SCHOOL:
HEAD COACH:

In addition to basic athletic training supplies, the athletic training area will be equipped with ice bags, ice and hot packs.

Will you have a team physician with you? / YES / NO
Physician’s Name:
Will you have a certified athletic trainer with you? / YES / NO
Athletic Trainer’s Name:
Will you have a student trainer with you? / YES / NO
Student Trainer’s Name:
Do you have any athletes with a medical condition we need to be aware of before the championship starts?
YES / NO

If yes, please state athlete(s) and condition(s):

Do you have any athletes on regular medication, any allergies or allergic to bee stings that we need to be aware of before the tournament starts?
YES / NO

If yes, please state athlete(s) and condition(s) and medications(s) and/or bee stings

Do you have any athletes that have specific treatments or taping/bracing that we need to be aware of before the tournament starts?
YES / NO

If yes, please state:

Please forward this completed form and direct any athletic training questions to the individual listed below.

Dan Strohecker

Office: (912) 525-8445