Medical questionaire form

Medical questionaire form

Download Medical questionaire form




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Date added: 16.03.2015
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The purpose of this questionnaire is to help protect you against possible illness that may be . The form is located online at: http://uphys.msu.edu/forms/. This form is in accordance with the American College of Sports Medicine guideiines for risk stratification when followed correctly by your trainer. Your trainer Please answer the questions on this form in BLOCK CAPITAL letters using BLACK INK. Title: Surname: Questionnaire to assess your medical fitness to drive.

Medical History Questionnaire. This form is voluntary. You may ignore it, complete parts of it, or fill it out fully. It is intended solely for your self-protection at sea, If you are not registered with a doctor – please state this on the form. Emergency contact information. Name: Relationship: Telephone number. Sports specific With your medical questionnaire(s) you will also receive a GP claim form. It is up to your doctor to fill this in and return it to DVA if they wish to obtain payment forthe questions and explain any that you do not understand. Please fill in the entire form. 1. Are you being treated for any medical condition at the present or have Medical History Questionnaire. This is your medical history form, to be completed prior to your first training session. All information will be kept confidential.

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