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- USA Hockey Consent To Treat/Medical History Form 2017
Get USA Hockey Consent To Treat/Medical History Form 2017-2024
, (athlete participant), or for myself as an adult participant, give my consent to USA Hockey and its medical representative to obtain medical care from any licensed physician, hospital, or clinic for the above mentioned participant, for any injury that could arise from participation in USA Hockey sanctioned events. If said participant is covered by any insurance company, please complete the following: Insurance Company: Poli.
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USAH FAQ
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Call your local program Registrar to request a claim form, or if you do not know who to call locally, please call USA Hockey at 800 566 3288, x123. If you have no other insurance, then your USAH plan will be the primary plan with a $3,500 deductible. DO NOT DELAY getting a claim form or submitting to K&K Insurance.
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To make a report to USA Hockey, you may do so either by: (1) clicking on “Report to USA Hockey” and completing the Reporting Form, (2) emailing to usahockeysafesport@usahockey.org, or (3) calling 800-888-4656.
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Be fair and impartial at all times. Answer all reasonable questions and requests. Adopt a “zero tolerance” attitude toward verbal or physical abuse. Never use foul or vulgar language when speaking with a player, coach or parent.
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Mandatory Reporters to the U.S. Center for SafeSport Or can be reported directly to USA Hockey at usahockeysafesport@usahockey.org, who will in turn forward the information to the Center. *Reporting to the Center and/or USA Hockey DOES NOT satisfy any legal reporting requirements under state or federal law.
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Call your local program Registrar to request a claim form, or if you do not know who to call locally, please call USA Hockey at 800 566 3288, x123. If you have no other insurance, then your USAH plan will be the primary plan with a $3,500 deductible. DO NOT DELAY getting a claim form or submitting to K&K Insurance.
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(b) A “GAME MISCONDUCT” penalty involves the suspension of a player or Team Official for the balance of the game with immediate substitution taking place on ice.
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Call your local program Registrar to request a claim form, or if you do not know who to call locally, please call USA Hockey at 800 566 3288, x123. If you have no other insurance, then your USAH plan will be the primary plan with a $3,500 deductible. DO NOT DELAY getting a claim form or submitting to K&K Insurance.
-
To make a report to USA Hockey, you may do so either by: (1) clicking on “Report to USA Hockey” and completing the Reporting Form, (2) emailing to usahockeysafesport@usahockey.org, or (3) calling 800-888-4656.
-
Be fair and impartial at all times. Answer all reasonable questions and requests. Adopt a “zero tolerance” attitude toward verbal or physical abuse. Never use foul or vulgar language when speaking with a player, coach or parent.
-
Mandatory Reporters to the U.S. Center for SafeSport Or can be reported directly to USA Hockey at usahockeysafesport@usahockey.org, who will in turn forward the information to the Center. *Reporting to the Center and/or USA Hockey DOES NOT satisfy any legal reporting requirements under state or federal law.
-
Call your local program Registrar to request a claim form, or if you do not know who to call locally, please call USA Hockey at 800 566 3288, x123. If you have no other insurance, then your USAH plan will be the primary plan with a $3,500 deductible. DO NOT DELAY getting a claim form or submitting to K&K Insurance.
-
(b) A “GAME MISCONDUCT” penalty involves the suspension of a player or Team Official for the balance of the game with immediate substitution taking place on ice.
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