Wisconsin's WIAA version of the wrestling skin lesion release documents a wrestler's diagnosis, contagious status and treatment so officials can let the wrestler compete. It adds contagious and non-contagious checkboxes, a license number field and a note telling officials how long the form stays valid.
An MD, DO, PA or APNP completes the whole form legibly, including diagnosis, contagious status, lesion diagram, medication name, dose, frequency and days prescribed, treatment start, expiration and return dates, license number and signature.
Download the current version from the source each time; forms change without notice.
Medical Release Form for Wrestler to Participate with Skin Lesion
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The provider signature line lists M.D., D.O., P.A. and A.P.N.P., and the note to officials refers to lesions identified by an MD, DO, PA or APNP. The provider must give a legible name, license number, office phone and office address.
Officials may consider it valid within the current season as long as the lesion stays consistent with the description and location on the form. The provider also enters an expiration date for the specific lesion, and officials can request new screening if lesions change.
The medication field asks for the name of each medication used to treat the lesions, the dose, the frequency and the number of days prescribed. The provider also enters the date and time treatment started and the earliest date the wrestler may return.