How to Fill Out and Submit the USA Hockey Consent to Treat Form

The USA Hockey Consent to Treat form is a one-page document that lets USA Hockey and its medical representatives arrange emergency medical care for a registered player injured during a sanctioned event. Download the PDF, complete the medical history and insurance sections, sign the consent statement, and hand the signed form to your team manager before the first practice of the season. Parents or legal guardians sign for minor players; adult participants sign for themselves.¹

Where to Download the Form

The national version is available as a PDF from USA Hockey’s forms portal at portal.usahockey.com.¹ Your club registrar or team manager can also provide a copy. Some associations use their own version during the regular season and reserve the national form for district and national championship credential checks, so ask your team manager which one your club requires.² Print the form and complete it by hand, or type into the PDF fields before printing if your software supports it.

Completing the Medical History

The top of the form is a checklist of conditions a first responder needs to know about: head injury or concussion history, fainting spells, convulsions or epilepsy, neck or back injury, asthma, high blood pressure, kidney problems, hernia, heart murmur, allergies, and diabetes. An “Other” field catches anything not on the list. Check every box that applies, then flip to the back of the page and describe the condition and its implications for first aid treatment.¹

Three yes-or-no questions follow. Has the participant had a recent tetanus booster, and if so when? Is the participant currently taking any medications? Has a doctor placed any restrictions on the participant’s activity? If you answer yes to the medication or restriction questions, list the medications and explain the restrictions on the back. Don’t leave the medication field blank if there’s anything to list. An emergency physician who doesn’t know a player uses a rescue inhaler or takes a blood thinner is working without information they need.¹

Emergency Contact, Physician, and Insurance

The form provides space for one emergency contact. Enter the full name, phone number, street address, city, state, and zip code. Choose someone reachable during games and practices who can make medical decisions for the player. Below that, fill in the player’s primary care physician’s name and phone number along with the family’s hospital of choice. Paramedics use the hospital preference when deciding where to transport a conscious, stable patient if the family isn’t on scene to speak up.¹

The insurance section asks for the insurance company name and policy number. These fields are conditional. The form says to complete them “if said participant is covered by any insurance company.” If the player is uninsured, leave the fields blank rather than guessing. Wrong policy information creates billing confusion at the hospital. Pull the exact company name and policy number from the front of the insurance card.¹

Signing the Consent Statement

The consent statement itself is short. By signing, the parent or guardian (or the adult participant) gives consent to USA Hockey and its medical representative to obtain medical care from any licensed physician, hospital, or clinic for any injury arising from participation in USA Hockey sanctioned events. The authorization is limited to injuries during those sanctioned activities. It is not a general power of attorney over the player’s medical care.¹

The signature line reads “Parent/Guardian/Adult Participant Signature” and is followed by a date field. A minor needs a parent or legal guardian to sign. An adult player signs for themselves. The form does not require notarization.¹

Submitting the Form

Give the completed form to your team manager before the first practice or game of the season. Team managers keep the signed Consent to Treat forms for every rostered player and bring the binder, along with rosters and waivers, to all games.³ If a player is hurt, the manager hands the form directly to the responding paramedics. That handoff is the moment the medical history on the back of the page does its work.

Keep a personal copy at home. Consider giving one to any other adult who regularly transports your player. If anything on the form changes during the season, such as a new medication, a new diagnosis, or a change in insurance, complete a fresh form and get it to the team manager so the binder stays current. When the season ends and the form is no longer needed, shred it rather than throwing it away. The page contains medical history and insurance details that shouldn’t end up loose in the trash.

Tournament Credential Checks

For teams advancing to district or national championships, the national version of the form is specifically required as part of credential verification.² Tournament officials check that every rostered player has a completed Consent to Treat on file. A missing or unsigned form at credential check can keep a player off the ice, so confirm well before travel that each form is signed, dated, and in the manager’s binder.

When to Fill Out a New One

USA Hockey memberships are valid through November 30 of the following season. A 2025–26 membership expires on November 30, 2026, and membership applications for the next season open on May 1.⁴ Because the form is tied to the player’s current registration, complete a new one each season when you renew membership. Treat the previous year’s form as expired once the registration year it was signed for ends.

What the Form Does Not Cover

The Consent to Treat authorizes medical care. It does not authorize international travel. If your team plays tournaments in Canada, any player under 19 traveling without both parents should carry a separate travel consent letter signed by the absent parent. Canadian border officials may request it, and not having one can lead to delays or denied entry. A travel consent letter should include the legal names of the child and accompanying adult as they appear on passports, the specific travel dates and destination, and contact information for the parent who can verify the trip. Carry the original signed letter and bring copies of the child’s passport and the trip itinerary. If a custody order or parenting arrangement is in place, pack a copy of that too.⁵

1
USA Hockey. Consent To Treat/Medical History Form
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USA Hockey. Associations Are Required to Instruct All Their Members to Register
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USA Hockey. Team Manager
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USA Hockey. 2026-27 Membership Rules and Policies
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Travel.gc.ca. Consent Letter for Children Travelling Outside Canada