| Arizona Sports Concussion Center Forms |
Please fill out the forms below and bring them with you to your testing appointment.
If you have never had a concussion, you do not need to fill out Section II in the Registration and Background Information form.
PLEASE be sure to print a copy of your forms for your own personal records prior to submitting any information. |
| If you prefer to Fax or Email your information, please download the forms below, fill them out, and fax them to: 480-347-2606 |
| Registration & Background Info Form |
|
|
| Documents are availabe in Adobe™ PDF. |
| HIPAA Privacy Info |
|
|
| Release of Info |
|
|
| Medical Release |
|
|
| Excuse from Physical Activity |
|
|
| Excuse from School |
|
|
| HIPAA Privacy Authorization Form |
|
|
If you are having trouble viewing the available PDF documents, you might need to update your Adobe Acrobat software. |
| |
|
|
| |
