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LOCKEAN ATHLETIC MEDICINE Timothy D. Lockean MD PATIENT REGISTRATION Patient Name: M or F Last Birth Date: First / / Middle Initial Age: Gender SS#: Home Address: Street Apt. # City State Home Phone:

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How to fill out athletic medicine

01

Gather all necessary medical information such as previous injuries, allergies, and current medications.

02

Complete the patient information section including name, contact information, and insurance details.

03

Provide a detailed medical history including any previous surgeries, illnesses, or chronic conditions.

04

Fill out the section for current symptoms or concerns, including the reason for seeking athletic medicine.

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If required, provide information about any ongoing treatment or rehabilitation programs.

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Mention any specific goals or expectations for the athletic medicine process.

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Sign and date the form to confirm that the provided information is accurate and complete.

Who needs athletic medicine?

01

Athletic medicine is beneficial for athletes of all levels, including professional athletes, college athletes, high school athletes, and recreational athletes.

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It is particularly important for individuals who participate in high-intensity sports activities or have a history of sports-related injuries.

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People seeking to improve their athletic performance, prevent injuries, or recover from sports-related injuries can also benefit from athletic medicine.

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Coaches, trainers, and sports medicine professionals often rely on athletic medicine to support their athletes and provide appropriate care.

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What is athletic medicine?

Athletic medicine is a branch of sports medicine that focuses on the treatment and prevention of injuries related to physical activity and sports.

Who is required to file athletic medicine?

Athletic medicine is typically filed by sports teams, athletes, and individuals involved in physical activities.

How to fill out athletic medicine?

Athletic medicine can be filled out by providing details of any injuries or medical conditions related to sports or physical activities.

What is the purpose of athletic medicine?

The purpose of athletic medicine is to ensure the health and safety of athletes and individuals participating in physical activities.

What information must be reported on athletic medicine?

Information on injuries, medical conditions, treatment plans, and preventive measures must be reported on athletic medicine forms.

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