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Golf Cart Request Form

** IMPORTANT INFORMATION **
 
This completed Golf Cart Request Form together with the medical report from the physician who has evaluated your condition must be submitted to the USGA WITHIN FIVE (5) DAYS of the electronic submission of the USGA Championship entry application. Incomplete or late submissions may result in insufficient time to evaluate. All submissions are confidential and reviewed solely for the purpose of evaluating the cart request.

As part of the review process by the USGA's medical panel, please discuss with your physician what additional information pertaining to your ability to walk the course can be provided by your physician to the USGA for review (such as a summary of surgeries, diagnostic studies, laboratory tests, treatments, medications, clinical notes and other relevant medical information specific to the diagnosis and management of the disability) and submit any such information that you or your physician believe would help the USGA assess the degree of your impairment with the physician's medical report.

Please provide a current medical report from your physician who has evaluated your condition.
In addition, please ask your physician to include the following information in the report:
a) The name of the disability,
b) The extent of the disability,
c) The prognosis for improvement,
d) The current objective abnormalities and how it impedes upon your ability to walk in general and during a golf tournament,
e) How far you are able to walk without stopping,
f) What prohibits you from walking further,
g) How long you are able to stand,
h) Whether you use ambulatory aids and if so, the length of time and circumstances under which these aides are used.

Please do not provide information about any other disability or medical condition unless it also relates to the disability that led to the cart request.