Get the free WVSA Medical Release Form.doc

WEST VIRGINIA SOCCER ASSOCIATION PO BOX 3360 BECKLEY, WV 25801 8008949872 × 3042529872 × 3042529878 (FAX) Webb: www.wvsoccer.net E Mail: office soccer.net MEDICAL RELEASE FORM Function: Players

How to fill out wvsa medical release formdoc

How to fill out wvsa medical release formdoc:

1. Obtain the form: The first step is to obtain the wvsa medical release formdoc. This can be done by requesting it from the West Virginia State Athletic Association (WVSA) or downloading it from their official website.
2. Personal information: Start by filling in your personal information such as your full name, address, date of birth, and contact details. Make sure to provide accurate and up-to-date information.
3. Authorization: The form typically requires you to authorize the release of your medical information. Read the authorization statement carefully and understand what you are consenting to. If you agree, sign and date the form accordingly.
4. Medical provider details: You will be asked to provide the name, address, and contact information of your primary healthcare provider. This is important as it allows the WVSA to communicate with your healthcare provider if necessary.
5. Emergency contact: Fill in the details of your emergency contact person. Include their full name, relationship to you, and contact information. This is vital in case of any medical emergencies during athletic activities.
6. Medical history: Provide a comprehensive medical history by answering the questions regarding pre-existing medical conditions, allergies, medications, and any recent surgeries or injuries. Be honest and thorough in this section as it helps the WVSA have a better understanding of your medical background.
7. Payer information: If you have medical insurance, provide the details of your insurance provider, policy number, and any other relevant information. This ensures that in case of any medical expenses, they can be appropriately billed.
8. Consent for treatment: In this section, you may need to provide consent for medical treatment if deemed necessary during WVSA activities. Read the statement carefully and sign accordingly.

Who needs wvsa medical release formdoc:

1. Athletes: Any individuals participating in official athletic activities organized or governed by the West Virginia State Athletic Association may need to fill out the wvsa medical release formdoc. This includes both amateur and professional athletes.
2. Parents or guardians: If the athlete is a minor (under 18 years of age), their parents or legal guardians will typically be required to fill out and sign the form on behalf of the athlete.
3. Coaches and team officials: In some cases, coaches and team officials may also be required to fill out and submit the wvsa medical release formdoc. This ensures that they have access to necessary medical information in case of emergency situations.

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What is wvsa medical release formdoc?

The WVSA medical release formdoc is a document that allows medical professionals to release medical information to designated individuals or organizations.

Who is required to file wvsa medical release formdoc?

Patients or individuals who wish to authorize the release of their medical information are required to fill out the WVSA medical release formdoc.

How to fill out wvsa medical release formdoc?

To fill out the WVSA medical release formdoc, patients need to provide their personal information, specify the recipients of the medical information, and sign the document.

What is the purpose of wvsa medical release formdoc?

The purpose of the WVSA medical release formdoc is to allow medical professionals to share a patient's medical information with specified individuals or organizations for treatment or other purposes.

What information must be reported on wvsa medical release formdoc?

The WVSA medical release formdoc typically requires the patient's name, date of birth, contact information, the name of the medical provider, and details of the information to be released.