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Physical Consent Form - Richland College - richlandcollege

Physical Consent Form - Richland College - richlandcollege 2025

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The document is a Consent for Treatment Form for student-athletes at Richland College, part of the Dallas County Community College District. It collects personal and medical information from students participating in athletics, including consent for evaluation and treatment of injuries by medical staff. The form outlines the responsibilities regarding insurance coverage for athletic injuries and requires signatures from both the student-athlete and a parent if under 18. Additionally, it includes sections for personal history, family history, injury history, and a physical examination by a licensed health professional.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the Contact Information section. Enter the date, sport, and your personal details including name, age, birthdate, and address. Ensure all fields are completed accurately.
In the Consent for Treatment section, read through the consent statement carefully. If you agree, sign and date where indicated. If you are under 18, a parent must also sign.
Proceed to Personal History. Answer all questions thoroughly without leaving any blank spaces. This includes childhood diseases, allergies, significant medical conditions, and current medications.
Complete the Family History section by checking applicable conditions that exist in your family. Provide additional details as necessary.
Fill out the Injury History section by answering all questions regarding past injuries or medical issues that may affect your participation in sports.
Finally, ensure that a licensed health professional completes the Physical Examination section with their findings and recommendations for athletic participation.

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