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SPORTS MEDICINE DEPARTMENT SOMERVILLE PUBLIC SCHOOLS Michelle Kelly, ATC, L 617.625.6600 × 6160 mkelly@k12.somerville.ma.usMOUTH GUARD EDUCATION FORM Soccer/Basketball The MIA HIGHLY RECOMMENDS mouth
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How to fill out mouth guard education form

01
Start by obtaining a mouth guard education form from the appropriate source, such as a dentist, coach, or sports organization.
02
Read the instructions and requirements on the form carefully.
03
Fill out your personal information, including your full name, contact details, and date of birth.
04
Provide details about the purpose of needing a mouth guard, such as participating in a specific sport or undergoing dental treatment.
05
Answer any additional questions or provide any necessary information requested on the form.
06
Review the completed form to ensure all information is accurate and legible.
07
Sign and date the form at the designated spaces.
08
Submit the filled-out form to the appropriate recipient, which could be your coach, dentist, or sports organization.
09
Keep a copy of the filled-out form for your records.

Who needs mouth guard education form?

01
Any individual who participates in contact sports or activities that pose a risk of dental injury may need a mouth guard education form.
02
This includes athletes involved in sports like football, hockey, rugby, martial arts, boxing, lacrosse, etc.
03
Furthermore, individuals undergoing dental treatment or seeking orthodontic care may also require a mouth guard education form to ensure they understand the importance of protecting their teeth.
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The mouth guard education form is a document that provides information on educating individuals about the importance and proper use of mouth guards.
Dentists, sports organizations, and schools are required to file the mouth guard education form.
The mouth guard education form can be filled out online or in person by providing details about the education program and the individuals who were educated.
The purpose of the mouth guard education form is to ensure that individuals are educated on the importance of using mouth guards during sports activities.
The information that must be reported on the mouth guard education form includes the date of the education program, the number of individuals educated, and the type of education provided.
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