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Return To Sports Instructions
WHAT YOU NEED TO KNOW:
Your child may need to give his school or coach a return to sports form after an illness, injury, or procedure. Ask your child's healthcare provider to fill out this release. Make copies of the form. Keep one copy and give another copy of the completed form to your child's school or coach.
Date of illness, injury, or procedure:Do not return to sports until your child's healthcare provider says it is okay.
- May return to sports with the following restrictions:
- May return to sports with NO restrictions on:
- Follow-up visit information:
Healthcare provider's signature:
Date of last medical evaluation (if different than above):
Medical healthcare provider's name and information (please print):
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.