Ringside Medical Officer Assessment
Use this form to assess a medical officer’s readiness, experience, and operational capability for ringside event coverage.
Assessment Basics
Full Name
*
First Name
Middle Name
Last Name
Professional Role / Title
*
Organization / Clinic Name
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Email
Phone
Text Message
Other
Event Name or Ring / Venue Assignment
Licensure and Experience
Medical Specialty or Training Area
*
Please Select
Emergency Medicine
Family Medicine
Internal Medicine
Sports Medicine
Anesthesiology
Pediatrics
Orthopedics
Paramedicine
Nursing
Other
Years of Relevant Experience
*
Ringside or Sports-Event Medical Experience
*
None
Limited (1-2 events)
Moderate (3-10 events)
Extensive (11+ events)
Current Certification Status
*
Please Select
Current and in good standing
Recently renewed
Pending renewal
Not currently held
Other
Relevant Credentials or Training Completed
Advanced Life Support
Trauma Care Training
Event Medical Coverage Training
Concussion Management
Return-to-Play Training
Airway Management Training
Other
Operational Readiness
Emergency response capability
*
1
2
3
4
5
Airway management readiness
*
1
2
3
4
5
Trauma assessment readiness
*
1
2
3
4
5
Communication equipment familiarity
*
1
2
3
4
5
Evacuation coordination readiness
*
1
2
3
4
5
Familiarity with venue protocols
*
1
2
3
4
5
Medical Coverage Capability
Types of Events You Can Cover
*
Boxing
Mixed Martial Arts
Wrestling
Kickboxing
Other
Maximum Event Duration You Can Support (Hours)
*
On-Site Support Capabilities
*
Pre-Fight Medical Checks
Ringside Monitoring
Post-Event Evaluation
Emergency Response Coordination
Athlete Transport Support
Other
Equipment or Assistance Required from the Venue
Availability or Session Preference
Scenario and Protocol Assessment
How would you manage an athlete with a suspected concussion at ringside?
*
If a boxer sustains a cut that is actively bleeding but not deep, what is the best immediate action?
*
Allow play to continue with observation
Request the bout be paused for assessment
Stop the contest immediately
Other
When should you escalate care to emergency transport during an event?
*
Only after loss of consciousness
When there is any suspected serious injury or deterioration
Only if the referee requests it
Other
Describe how you would communicate a medical concern to the referee and event officials.
*
Rate your confidence in deciding when to stop or delay a contest due to medical risk.
*
1
2
3
4
5
Rate your adherence to ringside medical protocols under pressure.
*
Needs Improvement
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Needs Improvement, 10 is Excellent
Declarations and Submission
Additional Comments
Submit Assessment
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