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MEDICAL RELEASE FOR RETURN TO ATHLETIC PARTICIPATION FOLLOWING A CONCUSSION OR OTHER INJURY Students Name: Date of Injury: This release is to certify that the above named student has been examined
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Return completed forms to the designated department or individual.
All individuals or entities that are requested to do so.
Fill out the forms completely and accurately with the required information.
The purpose is to provide necessary information as requested by the recipient.
Any information requested by the recipient that is relevant to the form.
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