Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
NVA Soccer Medical Screening Sign-Up
Please complete this form to request a NVA Soccer Medical Screening. You can sign up 2 athletes per form. For any questions or concerns, please don't hesitate to reach out to our office at 703-729-5010 or email tcocrane@nationalsportsmed.com At this appointment, we will perform a Functional Movement Screening, complete a DXA body composition scan and review your personal and family medical history with our physicians to identify any unique needs as they pertain to sports participation. Please note that we are not clearing or disqualifying you from participation; The purpose of the medical screening is simply to ensure that there are no red flags that our practice should be concerned about in regards to your involvement in sport.
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Athlete Name
*
First
Last
Parent or Guardian Name
First
Last
(Required if athlete under 18 years old)
Email
*
For appointment confirmation and communication.
Phone
*
For appointment confirmation and communication.
Is the above athlete an existing patient with our practice?
Yes
No
Unknown
Would you like to schedule for another athlete?
Yes
No
Athlete Name (2)
First
Last
Is the above athlete an existing patient with our practice?
Yes
No
Unknown
We have blocked the following days from 1:00PM to 3:30PM to serve NVA athletes with the most individualized care. Please select at least 1 of the following for your screening. And remember, these are first come, first serve!
*
Thursday, July 10
Friday, July 11
Tuesday July 15
Thursday, July 17
Friday, July 18
Tuesday, July 29
Thursday, August 14
Friday, August 15
These days don't work for me.
If these days don't work with your schedule, don't worry! We'll do everything we can to accommodate your athlete, just call our front office at 703-729-5010 and let them know. Be sure to mention you're an NVA athlete!
What days work best for you?
Monday Afternoon 1:00 PM - 3:30 PM
Tuesday Morning 8:00 AM - 11:30 AM
Tuesday Afternoon 1:00 PM - 3:30 PM
Thursday Morning 8:00 AM - 11:30 AM
Thursday Afternoon 1:00 PM - 3:30 PM
Friday Morning 8:00 AM - 11:30 AM
Friday Afternoon 1:00 PM - 2:30 PM
Select up to 3 choices. We'll do everything we can to accommodate your athlete, just call our front office at 703-729-5010 and let them know. Be sure to mention you're an NVA athlete!
Additional Comments
Do you have any specific concerns you'd like to speak with our providers about? This is a great educational opportunity for you as an athlete and your family!
Book Appointment