Return to Participation in Sports following Injury
5.11.3.1
Any athlete
injured during practice or game competition who requires a visit to the hospital or
doctor's office or any athlete removed from a game or practice by the coach, and
advised by coach to see a doctor will need written permission from the doctor before
returning to active participation.
Written
permission from the doctor should be documented on the Medical Report form issued by
the Athletic Department. The physician must indicate specific recommendations as
related to any restrictions as well as the time frame to elapse prior to return to
participation.
Completed
Medical Report forms must be submitted by the student to the Athletic Director,
Coach, and High School Principal.
Adopted: March 4, 1986
March 18, 1986
MILLIS HIGH SCHOOL ATHLETIC DEPARTMENT
MEDICAL REPORT
NAME
AGE
DATE
DATE
INJURED:
SPORT:
PRACTICE ___ GAME
___
DESCRIPTION OF INJURY:
X-RAY FINDINGS
DIAGNOSIS:
TREATMENT:
RECOMMENDATIONS
COMMENTS
___ 1. No practice until seen by: ___________________________________________
___ 2. No practice until __________________________________________________
___ 3. Running only - no contact until ______________________________________
___ 4. Practice - but no contact until
________________________________________
___ 5. No restrictions
___ 6. Other
___________________
___________________
___________________
Physician
Coach
Parent
Please return as soon as possible, as the athlete will be restricted from ALL
ACTIVITY until we receive status of injury.