Practice Medical

Contact Details
Legal NameAdam Davies
EmailEmail hidden; Javascript is required.
Phone+44 7577 160875
TeamMasters Team
Jersey #31
Date of Birth15/02/1975
Next of Kin DetailsIn the case of emergency, who is the best person to contact
NameEmily Rose
RelationCivil Partner
Phone07803703722
Travel & Accomodation Details
Travel ArrangementCar (Drove Self)
Inbound Airline
Inbound Airport Code
Inbound Flight #
Landing Date
Outbound Airline
Outbound Airport Code
Outbound Flight #
Departure Date
Car RegistrationLJ73 ZLW
Who's the Main Driver?
Travel Comments/Details
Hotel / Accommodation NameVillage hotel Glasgow
Others StayingPartner
Hotel / Accomodation Comments
Medical
Medical ConditionsYes
Condition Details

Sleep apnoea
Serve Reflux

Pre-existing injuriesYes
Injury Details

Shoulder instability - R
Broken Ribs x2 last season however healed

Medication(s)Yes
Medication Details

Omeprazole

AllergiesNo
Allergy Details
Agreements
Authority reporting Approval
  • agreed
Insurance Coverage
  • agreed
Medical Release
  • agreed
Sealand Seahawks

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