Weekend CRASH School
Physical Examination Form

Each participant must have a routine physical. We must have a signed statement from a doctor stating that you are medically cleared to participate in the program.

Print the Physical Exam Form (Your doctor may choose to use a similar form)

Fax or mail the forms to the program you are attending:

Weekend Program in Huntington, Vt

PSCC
855 Pine St.
Burlington, VT 05401

FAX: (802) 488-6201
Questions: (802) 488-6151

Weekend Program in White River Junction, Vt

Clara Martin Center
PO Box 816
Wilder, VT 05088

FAX: (802) 295-1312
Questions: (802) 295-1311

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