Multi-Sport Athlete Supplement Usage Disclosure Form
Athlete Information
Full Name
Sport(s)
School/Organization
Grade/Level
Supplement Usage
List all supplements you are currently using (vitamins, protein powders, energy drinks, etc.):
Supplement Name
Brand
Dosage/Amount
Frequency
Purpose
Have you consulted a coach, nutritionist, or physician before using any of these supplements?
Yes
No
Additional Information or Concerns
Agreement & Signature
I confirm that the information provided above is accurate and complete to the best of my knowledge.
Athlete Signature
Date
Parent/Guardian Signature (if under 18)
Date