Consent for On-site Sports Medicine Services

I hereby authorize Twin Cities Orthopedics (TCO) and its credentialed staff, including but not limited to athletic trainers, physical therapists, and strength and conditioning coaches to perform assessments, provide on-site treatment and/or strength and conditioning services to my child/athlete in connection with their participation in organized activities at their school. I understand that the nature and scope of services provided may vary by program.

I authorize TCO staff to communicate relevant medical and health information concerning my child/athlete with coaches, school personnel, instructors and/or other qualified healthcare providers involved in my child/athlete’s care, to the extent necessary to coordinate care and support safe participation in activities.
I acknowledge that participation is voluntary and that my child/athlete or I may decline or discontinue participation at any time.

Participant/Athlete: ________________________________________________

Parent/guardian signature: __________________________________________

Date: ________________________