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Student Waiver Form

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Life Savers Health Screening is working to decrease the incidence of Sudden Cardiac Death in young athletes.  One young athlete dies every three days in the United States from Sudden Cardiac Death.  Often there are no symptoms or the symptoms are ignored.  Lifesavers Health Screen provides cardiovascular ultrasound screenings for the student athletes.

The testing is simple, non invasive, and doesn't hurt.  Simply an ultrasound wand is placed on the childs chest at the level of their heart and a ultrasound picture is taken.  The student then has a simple EKG, where some leads are attached to sticky pads on their chest, and their heart beat is recorded.  That's it.  We give this information to the physician to read and review.

Most will be absolutely normal. In the event we were to find something suspicious we would notify you with a report of what the doctor saw and what he/she recommends.  It would be your responsibility to follow up with your child's physician on the results.  We would of course provide you with the necessary data for your child's physician to review.


If you approve and give permission for your child to have this screening.  Please fill out the information below:

Our Services


Fireside Chat with CEO/Founder

Fireside discussion with the founder about the importance of preventative health screenings.


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