To nominate an athlete please fill in the form below, attaching a word description of the athlete’s injury and rehabilitation program, which includes the following:
1. The athlete’s injury, including cause and severity.
2. The physician’s initial diagnosis and treatment protocol.
3. What role did the certified athletic trainer play?
4. The details of the rehabilitation program.
5. The details of the athlete’s conditioning program prior returning to competition.
6. The degree of success the athlete achieved returning to competition.
7. Dates of when above mentioned points (1-5) occurred.
8. Names, titles and phone number of the physician and certified athletic trainer who played a major role in the athlete’s comeback.
NOMINATION FORM
NAME OF ATHLETE:___________________________________________________
SCHOOL ATHLETE ATTENDS:__________________________________________
YOUR NAME:_________________________________________________________
YOUR AFFILIATION:___________________________________________________
YOUR ADDRESS:______________________________________________________
YOUR PHONE #:_______________________________________________________
ATHLETE’S ADDRESS:_________________________________________________
ATHLETE’S PHONE #:__________________________________________________
Send
nomination to:
Steve
Fryberger, MAT, ATC
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