W. Va. Code R. tit. 178, series 178-01, pt. 9, tbl. 178-1 H

Current through Register Vol. XLI, No. 24, June 14, 2024

Table 178-1 H - [Effective until 7/21/2024] MEDICAL AUTHORIZATION TO RETURN TO RIDE WHEN A JOCKEY HAS BEEN REMOVED DUE TO A SUSPECTED CONCUSSION

I, ______________________, have examined the jockey ____________________________________ who was removed from riding due to exhibiting signs/symptoms/behaviors consistent with a concussion. I have examined this athlete, provided an appropriate return to riding, if necessary, and determined that the jockey is cleared to resume participation on this date: ________________________________.

Signature of Authorized Medical Professional:

______________________________________________________________________________

Date: _____________________________________________

W. Va. Code R. tit. 178, series 178-01, pt. 9, tbl. 178-1 H