Elite Athletes: Medical Form

All athletes selected into a Bowls SA State Squad, are required to complete and submit the following information.

Bowls SA collects this information to ensure that those who are managing you while you are a part of a State Squad have all the relevant information needed to ensure your safety and wellbeing. We understand that privacy is important to you and your families and we will not use your personal information for any purpose other than that set out above without your consent.

If your situation changes, please let Bowls SA staff and your coach know asap. If you have any questions about the information being collected, please reach out to Bowls SA via reception@bowlssa.com.au.

All required questions are indicated by a red star eg. *

High Performance: Elite Athlete Medical Form – 2022/23
Name
Name
First
Last
Squad
Role
Address
Address
City
State/Province
Zip/Postal
Country
Are you of Aboriginal and/or Torres Strait Islander origin?

Consent

Please agree to the following statements regarding the collection and use of infomation collected via this form.
By completing this form, I consent to the collection of this information by Bowls SA for the purposes of medical treatment at Bowls SA tournaments, events or programs in accordance with the provisions of the Privacy Act 1988 (Cth).
I understand and agree that Bowls SA may only use or disclose this personal information to third parties, including approved Bowls SA engaged coaches/team managers/event providers for the purpose of my duty of care, OR to emergency service providers, for the purposes of medical treatment or any other directly related purpose.
Further I understand that if I do not supply any or all of the required information it will impact on the provision and effectiveness of any medical treatment rendered to me if required.
Name of parent/guardian completing this form on behalf of the athlete ( Only applicable to athletes under 18 years of age)
Name of parent/guardian completing this form on behalf of the athlete ( Only applicable to athletes under 18 years of age)
First
Last

General Medical History

Please provide details regarding your general health history

Allergies and Dietary Requirements

Please provide details regarding any allergies or dietary requirements.

Injury History

Please provide details regarding any current or historical injuries.

Medical & Allied Health Providers

Emergency Contact Details