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170 South Broadway Saratoga Springs, NY 12866 (518) 8868610 Mouth guard Information and Consent Form: Athletes Name: Date of Birth: Name of Parent or Legal Guardian: Relationship to Athlete: Address:

How to fill out Mouthguard Information and Consent Form

How to fill out Mouthguard Information and Consent Form

1. Start by reviewing the title of the form to ensure you have the correct document.
2. Fill in your personal details including name, age, and contact information in the designated sections.
3. Indicate any relevant medical history or dental issues that may affect the use of the mouthguard.
4. Read through the consent statements carefully and ensure you understand the implications.
5. Sign and date the form where indicated, confirming your consent for the mouthguard fitting and associated procedures.
6. If applicable, have a guardian or parent sign the form if the applicant is a minor.

Who needs Mouthguard Information and Consent Form?

1. Individuals participating in contact sports or activities where dental protection is necessary.
2. Athletes of all ages, particularly youth and amateur sports participants.
3. Patients who have been advised by a dentist to use a mouthguard for orthodontic or dental health reasons.

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What is Mouthguard Information and Consent Form?

The Mouthguard Information and Consent Form is a document that provides details about the mouthguard, including its purpose, usage, and associated risks. It also seeks consent from the participant or their guardian to use a mouthguard during sports or activities.

Who is required to file Mouthguard Information and Consent Form?

Athletes, especially minors, participating in sports that carry a risk of dental injury are typically required to file the Mouthguard Information and Consent Form. Parents or guardians usually sign on behalf of minors.

How to fill out Mouthguard Information and Consent Form?

To fill out the Mouthguard Information and Consent Form, the participant or guardian should provide personal information, review the information about mouthguards, acknowledge understanding of the risks, and sign the form indicating consent for use.

What is the purpose of Mouthguard Information and Consent Form?

The purpose of the Mouthguard Information and Consent Form is to inform participants about the importance of wearing a mouthguard, the risks involved in not using one, and to secure their consent for protection during sports activities.

What information must be reported on Mouthguard Information and Consent Form?

The information that must be reported on the Mouthguard Information and Consent Form includes the participant's name, age, sport, acknowledgment of risks, and signature of the participant or guardian confirming their consent.