2023-2024 Sport Medicine Information and Eligibility Forms
Thank you so much for taking some time to fill out each of our forms concerning your students health and for your student athlete eligibility. As a courtesy you will need the following items handy:
Insurance cards
Phone numbers
List of medications
List of allergies

When filling out these forms please make sure to use your student athletes name that will be on the roster. For example if Nathan Wayne is your students name but he goes by Wayne, then please list Wayne on his paperwork. This in turn makes it easier for us to find the information needed for insurance or emergency purposes.

For general interest you will be filling out the following forms:
Student Health History
Emergency Contact/Transportation
HIPAA Form
Consent to Treat
AAA Venue Consent and Release
Lake Hamilton Drug Testing Consent form

If there are any questions before filling out any of these forms please reach out to
    heidi.balliette@lhwolves.net
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I understand that if I do not complete ALL sections of this form that my student will be considered INELIGIBLE and will NOT play until this form is completed in its entirety. *
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