Treat My Injuries

TO BE FILLED OUT BY IMG ACADEMY ATHLETIC TRAINERS ONLY.

For student-athletes who suffer an injury that requires surgery.

Trainer Info
Your Full Name Your Full Name First Last
Your IMG Academy Email
Your Phone Number
Student-Athlete Info
Student-Athlete's Full Name Student-Athlete's Full Name First Last
Student-Athlete's Sport

Student-Athlete's Sport Baseball Basketball Football Golf Lacrosse Performance Soccer Softball Tennis Track & Field / Cross Country Volleyball
Student-Athlete's Scheduled Surgery Date Student-Athlete's Scheduled Surgery Date / MM / DD YYYY
Package Timing
When should the care package be delivered?

When should the care package be delivered? Before surgery After surgery
Package Contents

Every package automatically comes with an IMGA branded blanket, water bottle, ice pack, compression socks, sticker, rubber bracelet, and handwritten card.
Select Specialty Items Based on Injury

Select Specialty Items Based on Injury Crutch Covers Stretch Band N/A Other Other
Type of Injury & Any Other Important Information (e.g. include anything you'd like us to relay in the card)
Delivery Method
How should the package be delivered?

How should the package be delivered? Delivered on-site to the Athletic Trainer Mailed directly to the Student-Athlete
Delivery Details
Where on campus should we deliver it? (e.g. PCW Athletic Training room)
What is the student-athlete's mailing address? What is the student-athlete's mailing address?
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country