Medical Diagnostic Form For Athletes Who Are Participating In Ibsf Para-Sport Events (Page 3 of 4) in pdf

Medical Diagnostic Form For Athletes Who Are Participating In Ibsf Para-Sport Events Page 3

Full name: __________________________________________________________

Date:_______________

A+

B+ AB+ 0+

A-

B-

AB-

Blood type:

☐ No known allergies

Allergies:

☐Allergies

____________ Reaction: ____________________________________

GLASSES: ☐ Yes ☐ No

CONTACT LENSES: ☐ Yes ☐ No

Medication(s) currently used:

Attachments



The athlete’s health condition as stated on this form and the resulting impairment must fully explain the loss of

function exhibited by the athlete during athlete evaluation. Otherwise no sport class can be allocated by the

Classification Panel.

 Reports on additional testing by physicians, physiotherapists and other health professionals are welcomed, where

relevant, to complement the medical diagnostic information.

 The International Bobsleigh & Skeleton Federation and Classification Panel can ask for further information to be

submitted depending on the individual athlete’s health condition and impairment.

 Additional medical documentation must be in English (or translated into English by a certified translation agency)

Therefore, additional, recent and relevant medical documentation has to be attached to this

form in if the athlete has:

 an impairment or diagnosis that cannot be ascertained by clear signs and

symptoms;

 a complex or rare health condition, or multiple impairments;

 limb deficiency (amputation or dysmelia) at the level of an ankle, knee, (Xrays

for the respective joints to be enclosed);

 a spinal cord injury (recent ASIA scale results to be enclosed);

 one of the coordination related impairments in lower body - ataxia, athetosis or

hypertonia (Modified Ashworth Scale scores to be enclosed).

Medical Diagnostic Form For Athletes Who Are Participating In Ibsf Para-Sport Events Page 3