Sports Medicine Policy and Procedures

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Sports Medicine Policy and Procedures"

Transcription

1 Sports Medicine Policy and Procedures A. Introduction DEPARTMENT OF INTERCOLLEGIATE ATHLETICS Lourdes University Athletic Department strives to provide the highest quality of health care to each and every Student-Athlete participating in our intercollegiate athletic program. Lourdes University Student-Athletes have access to an extensive sports medicine program that focuses on prevention, treatment, and rehabilitation of athletic related injuries. Our Sports Medicine staff is comprised of two certified athletic trainers, one team physician that specializes in Physical Medicine and Rehabilitation, and multiple orthopaedic surgeons. We have an excellent and very comprehensive medical support system; all provided by ProMedica, the largest healthcare system in our region and has earned national recognition for high-quality, integrated care. B. Criteria for Participation a. Pre-Participation Physical Exam i. Freshman and Transfer Student-Athletes Lourdes University requires all freshman and transfer student athletes to go through a pre-participation physical examination prior to participating in organized practice or competition. Every Student-Athlete must have their physical examination on file. This physical examination is very comprehensive and will be arranged by Lourdes University Sports Medicine. The pre-participation physical examination will identify existing medical problems that might hinder athletic performance/physical health. A physical from any other physician is not allowed as a replacement for the one conducted by Lourdes University Sports Medicine. Freshman and Transfer Student-Athletes are required to log on to our online documentation system, ATS, to create a new account and thoroughly fill out all of our Athletic Policies and Forms. Directions for these New Student-Athletes can be found on our athletic website. Please print out a copy of your medical history and bring to your respective athletic physicals. Should you not have this paperwork with you and/or completed the online account information by 8am on the day prior to your scheduled physical; you will not be allowed to have your physical

2 completed. The athlete will then be required to obtain their athletic physical at our Team Physician's office at cost to them. **ATS Site Address is lourdes2.atsusers.com (do not use the prefix) ** ii. Returning Student Athletes Lourdes University requires all returning student athletes to complete an annual medical health update prior to the beginning of their respective season. All returning student athletes will be interviewed by an athletic trainer or physical therapist. Following the interview, each returning Student-Athlete will be examined by the team physician to discuss the course of treatment for any new medical conditions or injuries, and also deem whether or not the athlete is medically cleared for participation in their sport. Returning Athletes are required to log on to our online documentation system, ATS, to update any information that has changed since the previous year. Directions for these Returning Student-Athletes can be found on our athletic website. Should you not have updated your ATS account information by 8am on the day prior to their scheduled updated physical; you will not be allowed to have your updated physical completed. The athlete will then be required to obtain their athletic physical at our Team Physician's office at cost to them. ** **ATS Site Address is lourdes2.atsusers.com (do not use the prefix) iii. Walk-on/Tryout Student Athlete Physical Exam Lourdes University will not be responsible for an injury that may occur during a try-out prior to the pre-season physical examination. A waiver must be signed before any athlete can participate in a try-out. A student wishing to try-out for a team must also provide proof of an annual physical from a physician within the past six (6) months iv. Pre-Existing Medical Conditions/Injuries and/or Pre-Participation Physical Examination Findings Any or all pre-existing injuries or medical conditions must be reported and documented to the Lourdes University Sports Medicine Staff. This must be done prior to, or at the time of the initial pre-physical examination. Lourdes University will not be financially responsible for any bills that are generated by pre-existing or medical conditions found during the pre-participation physical examination.

3 C. Injury Care Plan An injury sustained during supervised practice or contest must be reported as soon as possible to the Lourdes University Sports Medicine Staff. An athletic trainer will do a primary evaluation. If trauma is beyond the athletic trainer s level of care, the athlete will be referred to our Lourdes University team physician or Emergency Center. A program of treatment and management will be prescribed. It is the athlete s responsibility to schedule treatment. The Lourdes University Sports Medicine Staff cannot be held liable if the athlete does not comply with the program that is prescribed. The decision to return to athletic participation will be made by the Sports Medicine Staff. Consistent communication between the Student-Athlete, Coaches and Sports Medicine Staff is essential for the overall care of each Student-Athlete. It is the Student-Athletes responsibility to report all athlete related injuries immediately to the Lourdes University Sports Medicine Staff. i. Injury Referral and Outside Consultation D. Athletic Insurance Coverage The Lourdes University Team Physician may determine that further evaluation is needed in the treatment and care of an athletic related injury. Appointments for such referrals will be made by a Lourdes University Athletic Trainer. Any unauthorized referral will be the sole responsibility of the athlete involved. If the athlete, their parents or guardian, spouse and/or seek outside care of any injury, the Athletic Department is not financially responsible for any and all charges pertaining to the unauthorized referral. The athlete will not be permitted to participate, after outside consultation, until: 1) a detailed written report has been received from the consulting physician; 2) an evaluation is made by the Lourdes University Sports Medicine Staff, and it has been determined that the athlete can demonstrate the necessary skills needed to resume participation. Insurance coverage for any injury sustained while participating in an intercollegiate sport at Lourdes University can be used as either a primary or a secondary accidental policy. Participation is defined as periods of official, organized athletic participation while under the general supervision of authorized University personnel or outside practice (i.e. open gym) in preparation for intercollegiate participation. For athletes without other health insurance, this policy can be used as their primary insurance for athletic related injuries. This policy can also be used as a secondary insurance to those athletes who have a primary insurance. Parental, guardian or personal insurance is the primary coverage. This means that the medical provider

4 will send medical bills incurred, as the result of injury in an intercollegiate sport, directly to the primary company or the athlete s home address. The Lourdes University policy will be secondary, thus assisting in the remainder of the medical bill after the primary coverage has responded. This is only the case when the injury is sustained during participation in practice or contest of an athlete s given sport. Lourdes University Athletic Insurance is provided by First Agency, Inc. The maximum lifetime benefit per athletic injury is $25,000. After the maximum lifetime benefit has been exhausted, the athlete is then responsible for any remaining balances. The first treatment expense must be incurred within 90 days from onset of the injury. Claim Procedure As previously stated all athletic injury referrals must be completed by Lourdes University Athletic Trainer. Once the referral has been made, the Athletic Trainer will complete a claim for the athletic injury and then submit it to the insurance carrier. Should any bills be received for treatment of the sustained injury, please contact the athletic trainer immediately. Please note that First Agency may request the primary insurance carrier s explanation of benefits (EOB) for the specific athletic injury. Please be prepared should the EOB be requested. Should termination of participation occur, Lourdes University will see out the care of any preestablished injury that occurred while participating in Lourdes University Intercollegiate Athletics. Lourdes University will not be responsible for the care of any injury that has not been previously reported once a decision to no longer participate as an intercollegiate athlete has been established (i.e. removal from team before eligibility has been completed). If the parents or Student-Athlete refuse to give primary insurance information or if false information is provided then Lourdes University will not be responsible for any medical bills incurred as a result of participation in intercollegiate athletics. Medical Bills All medical bills are the responsibility of the Student-Athlete. When a Student-Athlete receives an athletic related medical bill, it is their responsibility to make sure that all insurances were billed properly. The Lourdes University Sports Medicine Staff will gladly assist the Student- Athlete after an initial inquiry has been completed with the provider. Lourdes University cannot be held liable for expenses associated with non-participation related examination or testing. THE SPORTS MEDICINE STAFF MAY ASSIST THE STUDENT- ATHLETE BY MAKING NON-PARTICIPATION RELATED APPOINTMENTS. HOWEVER, IT SHOULD NOT BE ASSUMED THE ATHLETIC DEPARTMENT WILL COVER THE EXPENSES FORSUCH APPOINTMENTS.

5 E. Medical Disqualification or Exceptions to Participation a. Lourdes University Sports Medicine Staff reserves the right to medically disqualify a Student-Athlete under NAIA rules. If it has been medically determined that it is unsafe or detrimental to their long-term health of a Student-Athlete to continue participation in Intercollegiate Athletic, the Team Physician has ultimate authority to Medically Disqualify a Student Athlete from participation. b. Pregnant Athlete A Student-Athlete must report her pregnancy to the Team Physician as soon as possible to eliminate any health risks to both the mother and the fetus. All information pertaining to the pregnancy will be treated by a physician and confidential transaction. The athlete, her personal physician, and Lourdes University Team Physician will weigh the danger of athletic participation. If the decision is made to allow the pregnant athlete to participate, a document of understanding and waiver must be signed. c. Body Piercing Any body piercing (i.e. ears, nose, tongue, eyebrow, belly button, etc. ) may not be worn during participation of intercollegiate athletics at Lourdes University. Any injury resulting from wearing a piercing is the sole responsibility of the athlete. F. Other Sports Medicine Policies a. All Sport Medicine Policies can be found on the Lourdes University Athletic Website: i. Drug Testing Policy 1. All Student-Athletes of Lourdes University are subject to mass and random drug screens. ii. Concussion Policy 1. All Student-Athletes are required to read and electronically sign the Lourdes University Concussion Policy in ATS prior to participation. iii. Sickle Cell Policy 1. All Student-Athletes are required to read, fill out accurately, and electronically sign the Lourdes University Sickle Cell Policy in ATS prior to participation.

6 iv. Nutritional Supplement Disclosure Policy 1. All Student-Athletes are required to read, fill out accurately, and electronically sign the Lourdes University Nutritional Supplement Disclosure Policy in ATS, prior to participation. If you choose to take a supplement, you acknowledge the risk of losing your eligibility to participate in intercollegiate athletics if you test positive for an NAIA banned substance, regardless of the reason or purpose for taking such supplements. G. Odd and Ends a. Doctors, Physical Therapy, and Diagnostic Imaging Appointments i. Student-Athletes are responsible for making and remembering their own appointments. ii. Student-Athletes are required to be either early or on time for their appointments. iii. Cancelations are required to be made 24 hours in advance. b. Physician Exam Report i. Athletes are required to pick up a Physician Exam Report from the athletic training, prior to each visit to Sports Care Physicians c. Prescription Medications i. Prescription Medication are to be used by the prescribed athlete only!!!! ii. There will be major consequences should an athlete be found using unprescribed or distributing prescription medications to other athletes. H. Athletic Training Room Rules a. The athletic training room is a medical facility and should be treated as such. i. Be on time. In season sports take precedence over sports in nontraditional seasons. ii. Acutely injured athletes take precedence over all others iii. No treatment will be given before an injury is evaluated. iv. Missing an appointment without prior calling is not acceptable. Consequences will be determined by that athletes coach. v. Use appropriate language. vi. No food or drink with the exception of water is allowed in the athletic training room. vii. Do not wear shoes on the treatment tables. viii. Appropriate clothing must be worn. Practice gear, shorts, t-shirts. ix. Do not remove any equipment from the athletic training room without permission. x. Do not expect to be evaluated right before practice or games.

7 xi. Always treat Sports Medicine Staff with respect. xii. All over the counter medications (OTC) will be documented at the time of dispense. xiii. Always pick up after yourself.

8 Sports Medicine Policies and Procedures I have read and understand Lourdes University Sports Medicine Policies and Procedures. Print Parent s Name Parent s Signature Date Print Parent s Name Parent s Signature Date Print Athlete s Name Athlete s Signature Date

UNIVERSITY OF TOLEDO SPORTS MEDICINE POLICIES AND PROCEDURES

UNIVERSITY OF TOLEDO SPORTS MEDICINE POLICIES AND PROCEDURES 1 UNIVERSITY OF TOLEDO SPORTS MEDICINE POLICIES AND PROCEDURES 1. Athletic Insurance Coverage. Revised 2009 Insurance coverage for any injury sustained while participating in an intercollegiate sport at

More information

Central Michigan University Athletic Department Sports Medicine Services. Mission Statement. Section I Professional Medical Staff / Facilities

Central Michigan University Athletic Department Sports Medicine Services. Mission Statement. Section I Professional Medical Staff / Facilities Central Michigan University Athletic Department Sports Medicine Services Mission Statement "Central Michigan University Athletic Department is committed to providing all student-athletes a level of care

More information

II. Returning student-athletes must update their information each year.

II. Returning student-athletes must update their information each year. General Policies: The Alcorn State University Sports Medicine Program aims to provide prevention, treatment, and rehabilitation of athletic injuries and ensure the highest standard of medical care for

More information

SPORTS MEDICINE POLICIES AND PROCEDURES

SPORTS MEDICINE POLICIES AND PROCEDURES HILBERT COLLEGE SPORTS MEDICINE POLICIES AND PROCEDURES This policies and procedure manual pertains to the Athletic Department at Hilbert College. It is intended to give direction and answer questions

More information

Alabama A&M University Sports Medicine. Athletic Injury and Medical Policy

Alabama A&M University Sports Medicine. Athletic Injury and Medical Policy Alabama A&M University Sports Medicine Athletic Injury and Medical Policy General Policies: A comprehensive Sports Medicine Program of prevention, treatment, and rehabilitation has been developed to ensure

More information

GEORGE MASON UNIVERSITY. Intercollegiate Athletics Drug and Alcohol Education and Testing Program POLICY

GEORGE MASON UNIVERSITY. Intercollegiate Athletics Drug and Alcohol Education and Testing Program POLICY GEORGE MASON UNIVERSITY Intercollegiate Athletics Drug and Alcohol Education and Testing Program POLICY I. PURPOSE The Department of Intercollegiate Athletics at George Mason University (GMU) is concerned

More information

Davidson College Sports Medicine Football New Athlete Pre-Participation Letter

Davidson College Sports Medicine Football New Athlete Pre-Participation Letter Davidson College Sports Medicine Football New Athlete Pre-Participation Letter The Davidson College Sports Medicine Staff would like to welcome you to Davidson College. We look forward to working with

More information

Sports Medicine & Medical Insurance Policies. Samford University Department of Athletics

Sports Medicine & Medical Insurance Policies. Samford University Department of Athletics Sports Medicine & Medical Insurance Policies Samford University Department of Athletics Introduction: The Samford University Department of Athletics seeks to provide the highest quality health care to

More information

TARLETON SPORTS MEDICINE. Student-Athlete Medical Information

TARLETON SPORTS MEDICINE. Student-Athlete Medical Information TARLETON SPORTS MEDICINE Student-Athlete Medical Information TARLETON STATE UNIVERSITY ATHLETICS DEPARTMENT Box T-0080 Stephenville, TX 76402 254-968-9178 254-968-9674 FAX www.tarletonsports.com Dear Parent

More information

Sports Medicine Policies and Procedures

Sports Medicine Policies and Procedures Sports Medicine Policies and Procedures The Sports Medicine Department's mission is to work toward the prevention of athletic injuries, to care for those injuries that do occur, and to work towards complete

More information

FURMAN UNIVERSITY SPORTSMEDICINE CENTER

FURMAN UNIVERSITY SPORTSMEDICINE CENTER FURMAN UNIVERSITY SPORTSMEDICINE CENTER IMPORTANT INSURANCE INFORMATION Dear Parents: Furman University provides an excess coverage policy for our intercollegiate athletes. Incurred medical charges are

More information

UALR Sports Medicine PLEASE READ AND FOLLOW ACCORDINGLY Dear Parent or Guardian:

UALR Sports Medicine PLEASE READ AND FOLLOW ACCORDINGLY Dear Parent or Guardian: UALR Sports Medicine PLEASE READ AND FOLLOW ACCORDINGLY Dear Parent or Guardian: Enclosed is important information regarding athletic accident insurance that requires your immediate attention and response.

More information

ELMIRA COLLEGE SPORTS MEDICINE INFORMATION, POLICY AND PROCEDURE MANUAL FOR ATHLETES

ELMIRA COLLEGE SPORTS MEDICINE INFORMATION, POLICY AND PROCEDURE MANUAL FOR ATHLETES ELMIRA COLLEGE SPORTS MEDICINE INFORMATION, POLICY AND PROCEDURE MANUAL FOR ATHLETES Medical Eligibility for Freshman and Transfer Students: All students who wish to participate in intercollegiate athletics

More information

UNIVERSITY OF CENTRAL FLORIDA SPORTS MEDICINE DEPARTMENT Medical Care & Insurance Procedures

UNIVERSITY OF CENTRAL FLORIDA SPORTS MEDICINE DEPARTMENT Medical Care & Insurance Procedures UNIVERSITY OF CENTRAL FLORIDA SPORTS MEDICINE DEPARTMENT Medical Care & Insurance Procedures The University of Central Florida Athletic Association, Inc. (UCFAA) seeks to provide comprehensive athletic

More information

MEDICAL AND INSURANCE POLICIES & PROCEDURES Sports Medicine services are available to all student-athletes. Each intercollegiate athletic team has an

MEDICAL AND INSURANCE POLICIES & PROCEDURES Sports Medicine services are available to all student-athletes. Each intercollegiate athletic team has an MEDICAL AND INSURANCE POLICIES & PROCEDURES Sports Medicine services are available to all student-athletes. Each intercollegiate athletic team has an assigned certified athletic trainer, but any of the

More information

College of Idaho Athletic Training Policies and Procedures

College of Idaho Athletic Training Policies and Procedures The College of Idaho Department of Intercollegiate Athletics Substance Abuse Policy The College of Idaho recognizes abuse and misuse occurs on a large scale in society today. The continuing rises in the

More information

Northern Arizona University Athletic Training Insurance Requirements and Policies

Northern Arizona University Athletic Training Insurance Requirements and Policies Physician and Billing Procedures: Northern Arizona University Athletic Training Insurance Requirements and Policies Student athletes who sustain injuries while participating in an organized team practice

More information

NORTHWESTERN UNIVERSITY SPORTS MEDICINE DEPARTMENT Medical Care & Insurance Plan Document

NORTHWESTERN UNIVERSITY SPORTS MEDICINE DEPARTMENT Medical Care & Insurance Plan Document NORTHWESTERN UNIVERSITY SPORTS MEDICINE DEPARTMENT Medical Care & Insurance Plan Document The Northwestern University Department of Athletics and Recreation (NUDAR) seeks to provide comprehensive athletic

More information

FURMAN UNIVERSITY SPORTSMEDICINE CENTER

FURMAN UNIVERSITY SPORTSMEDICINE CENTER IMPORTANT INSURANCE INFORMATION Dear Parents: Furman University provides an excess coverage policy for our intercollegiate athletes. Incurred medical charges are to be filed with your insurance first.

More information

University of Nebraska Omaha Policies and Procedures Regarding Insurance and Medical Expenses

University of Nebraska Omaha Policies and Procedures Regarding Insurance and Medical Expenses University of Nebraska Omaha Policies and Procedures Regarding Insurance and Medical Expenses It is the policy of the UNO Athletic Department that all student-athletes be covered by a major medical health

More information

To the Parents of Varsity Athletes:

To the Parents of Varsity Athletes: To the Parents of Varsity Athletes: We are all familiar with rising health care costs. Valparaiso University, in studying its health costs annually, has to struggle with these same issues. Having reviewed

More information

Policies and Procedures Regarding Athletic Participation, Injuries, Illnesses and Medical Care

Policies and Procedures Regarding Athletic Participation, Injuries, Illnesses and Medical Care Office of Sports Medicine 2015-16 http://www2.kutztown.edu/about-ku/administrative-offices/sports-medicine-services.htm Policies and Procedures Regarding Athletic Participation, Injuries, Illnesses and

More information

Sports Medicine Policies & Procedures

Sports Medicine Policies & Procedures Sports Medicine Policies & Procedures The Sports medicine department is organized to provide high quality medical care to all student-athletes within intercollegiate athletic program. The health and well-being

More information

April 1, 2015. Dear Parents and Student Athletes,

April 1, 2015. Dear Parents and Student Athletes, April 1, 2015 Dear Parents and Student Athletes, Enclosed you will find a packet of information that includes a medical history, waivers, and insurance information forms which need to be filled out in

More information

Fairfield University Sports Medicine Department 1073 North Benson Road Fairfield, CT 06824

Fairfield University Sports Medicine Department 1073 North Benson Road Fairfield, CT 06824 June 1, 2015 The Fairfield University Sports Medicine Department requires that all student athletes complete several forms before they are eligible to participate with their athletic team in the upcoming

More information

CENTRAL COLLEGE PARENT/GUARDIAN/STUDENT INFORMATION FORM 2013-2014

CENTRAL COLLEGE PARENT/GUARDIAN/STUDENT INFORMATION FORM 2013-2014 CENTRAL COLLEGE PARENT/GUARDIAN/STUDENT INFORMATION FORM 2013-2014 RETURN COMPLETED FORM TO Central College Attn: Frank Neu Campus Box 6600, 812 University St. Pella, IA 50219 If you are filling this out

More information

Academy of Art University Sports Medicine Returning Student-Athlete Physical Packet

Academy of Art University Sports Medicine Returning Student-Athlete Physical Packet Attention: Returning Student-Athletes Academy of Art University Sports Medicine Returning Student-Athlete Physical Packet On Behalf of the Sports Medicine Department, we look forward to another healthy

More information

University of Pikeville Sports Medicine Policy Guide

University of Pikeville Sports Medicine Policy Guide University of Pikeville Sports Medicine Policy Guide MISSION The University of Pikeville Sports Medicine Department is committed to serving the Intercollegiate Athletic Department by protecting the health

More information

Solano College Sports Medicine Program

Solano College Sports Medicine Program Solano College Sports Medicine Program Mission: Our mission is to care for and treat all in-season (as described by CCCAA), Solano College Athletes, and their athletic injuries. Solano College Sports Medicine

More information

Christian Brothers University Medical Certification for individual Student Athlete Participation: MUST EACH 1. pre participation physical: 2. 3. 4.

Christian Brothers University Medical Certification for individual Student Athlete Participation: MUST EACH 1. pre participation physical: 2. 3. 4. Christian Brothers University Medical Care and Insurance Procedures (Revised 12/8/14) Medical Certification for individual Student Athlete Participation: Christian Brothers University requires all student-athletes

More information

Fact Page: Student-Athlete Information

Fact Page: Student-Athlete Information 1) University of San Diego Undergraduate Cost of Attendance: Estimated Cost of Attendance Full-Time (2011-2012 Academic Year) Per Semester: 12-18 Units Tuition $39,480 Fees $485 Room Board $8,610 $6,6168

More information

Medical Care & Insurance Procedures

Medical Care & Insurance Procedures Medical Care & Insurance Procedures Weatherford College (WC) Athletics Department seeks to provide comprehensive athletic training services for its student-athletes, including preventive services, first

More information

University of West Florida Sports Medicine

University of West Florida Sports Medicine University of West Florida Dear Argonaut, On behalf of the UWF Staff, I would like to welcome you to UWF and congratulate you on joining the UWF Athletic Department. I would like to take this time to inform

More information

PHYSICAL EXAMINATION FORM (ATHLETE) To be filled out by Health Care Provider

PHYSICAL EXAMINATION FORM (ATHLETE) To be filled out by Health Care Provider PHYSICAL EXAMINATION FORM (ATHLETE) To be filled out by Health Care Provider All full-time, undergraduate students must have a physical exam. PERSONAL DATA Name: Last First Middle Birthdate: Height: Weight:

More information

Athletic Training Department * 320 S. Main St. * Olivet, Michigan 49076 * Fax (269)-749-4144

Athletic Training Department * 320 S. Main St. * Olivet, Michigan 49076 * Fax (269)-749-4144 Athletic Training Department * 320 S. Main St. * Olivet, Michigan 49076 * Fax (269)-749-4144 Dear Student-Athlete and Parent(s)/Guardian(s): On behalf of the Olivet College Athletic Training Department,

More information

Department of Athletics Policy & Procedure Manual

Department of Athletics Policy & Procedure Manual 07/2007 03-07 1 of 3 GENERAL INFORMATION Each student-athlete must complete a comprehensive physical exam prior to participation in athletics at Southeast Missouri State University. Annual physical exams

More information

WEBER STATE UNIVERSITY SPORTS MEDICINE INTERCOLLEGIATE ATHLETICS DRUG ABUSE PROGRAM

WEBER STATE UNIVERSITY SPORTS MEDICINE INTERCOLLEGIATE ATHLETICS DRUG ABUSE PROGRAM WEBER STATE UNIVERSITY SPORTS MEDICINE INTERCOLLEGIATE ATHLETICS DRUG ABUSE PROGRAM The department of intercollegiate athletics at Weber State University its coaching personnel and administrators, strongly

More information

Dominican University of California Office of Athletic Training Athletic Insurance Policies and Procedures

Dominican University of California Office of Athletic Training Athletic Insurance Policies and Procedures Athletic Insurance Policies and Procedures 1. Insurance: a. Personal Insurance: Primary coverage. i. All Dominican university student athletes are required to have a full coverage medical insurance policy

More information

ATHLETIC PARTICIPATION MEDICAL PACKET (SOPHOMORES)

ATHLETIC PARTICIPATION MEDICAL PACKET (SOPHOMORES) ATHLETIC PARTICIPATION MEDICAL PACKET (SOPHOMORES) Dear Weatherford College Athlete, Athletic Training & Sports Medicine A new year of Weatherford College Athletics is quickly approaching. I hope this

More information

o Complete your Pre-participation Physical exam form, then take it to your sports physical appointment at the campus Health and Wellness Center.

o Complete your Pre-participation Physical exam form, then take it to your sports physical appointment at the campus Health and Wellness Center. Physical Paperwork Worksheet Team: Physical forms deadline: Athlete s Name YOU WILL MISS TRY-OUTS/ PRACTICE TIME IF YOU SUBMIT LATE, INCOMPLETE OR INACCURATE FORMS 1. Schedule your sports physical with

More information

SECTION 10: HEALTH SERVICES

SECTION 10: HEALTH SERVICES SECTION 10: HEALTH SERVICES SPORTS MEDICINE PROGRAM 1. The mission of the Division of Sports Medicine is to provide the best possible health care system for our student-athletes. The athletic training

More information

Grand Valley State University Department of Intercollegiate Athletics Medical Bill Payment Policies and Procedures

Grand Valley State University Department of Intercollegiate Athletics Medical Bill Payment Policies and Procedures Grand Valley State University Department of Intercollegiate Athletics Medical Bill Payment Policies and Procedures Section 1: Health Insurance Coverage/Permissible Medical Expenses 1. Grand Valley State

More information

SECTION VI SPORT ADMINISTRATION

SECTION VI SPORT ADMINISTRATION END OF SEASON REPORT SECTION VI SPORT ADMINISTRATION All head coaches are required to file with the Director of Athletics an end of season report with a copy to their immediate supervisor and the Director

More information

University of New Orleans Department of Sports Medicine Medical Care, Insurance, and Payment Policies and Procedures

University of New Orleans Department of Sports Medicine Medical Care, Insurance, and Payment Policies and Procedures University of New Orleans Department of Sports Medicine Medical Care, Insurance, and Payment Policies and Procedures The University of New Orleans Department of Sports Medicine seeks to provide comprehensive

More information

8. MEDICAL EMERGENCY ACTION PLAN

8. MEDICAL EMERGENCY ACTION PLAN SPORTS MEDICINE The Oberlin Club Sports Medical Program provides athletic training health care services to student-athletes who participate on Oberlin s Club Sports teams. The Oberlin Club Sports Medical

More information

SPORTS MEDICINE PRE-PARTICIPATION PHYSICAL EXAMINATION FORMS RETURNING ATHLETE

SPORTS MEDICINE PRE-PARTICIPATION PHYSICAL EXAMINATION FORMS RETURNING ATHLETE SPORTS MEDICINE PRE-PARTICIPATION PHYSICAL EXAMINATION FORMS RETURNING ATHLETE UNIVERSITY OF ARKANSAS ATHLETIC TRAINING DEMOGRAPHIC INFORMATION FORM Full Name: M F : (Last) (First) (MI) (Circle) (m/dd/yy)

More information

Pepperdine Athletic Training Center Policies and Procedures (6/2013)

Pepperdine Athletic Training Center Policies and Procedures (6/2013) Pepperdine Athletic Training Center Policies and Procedures (6/2013) The purpose of this section is to familiarize the student-athlete with the policies and procedures of the Athletic Training Center at

More information

2015-16 CHECKLISTS OF ATHLETIC TRAINING INFORMATION

2015-16 CHECKLISTS OF ATHLETIC TRAINING INFORMATION 2015-16 CHECKLISTS OF ATHLETIC TRAINING INFORMATION Returning GCU Student Athletes: Until these forms are complete and you have been released to practice by the Athletic Training Staff, you will not be

More information

The following is a checklist, for your personal use, of all the forms that must be returned to Manhattanville College Sports Medicine by August 1:

The following is a checklist, for your personal use, of all the forms that must be returned to Manhattanville College Sports Medicine by August 1: Dear new student athlete: The Sports Medicine Staff would like to take this opportunity to welcome you to Manhattanville College. We work to provide all student athletes with comprehensive health care

More information

SUNY ADIRONDACK. Sports Medicine Team & Athletic Training

SUNY ADIRONDACK. Sports Medicine Team & Athletic Training SUNY ADIRONDACK Sports Medicine Team & Athletic Training TABLE OF CONTENTS SUNY ADIRONDACK SPORTSMEDICINE TEAM MISSION CERTIFlED ATHLETIC TRAINER (ATC) SUNY ADIRONDACK ATHLETIC TRAINING INTRODUCTION STATEMENT

More information

With the goal of a drug free environment, Nebraska has developed the following program.

With the goal of a drug free environment, Nebraska has developed the following program. Substance Abuse Program for Student-Athletes The abuse and misuse of drugs and alcohol is a major problem for all segments of contemporary American society. Student-athletes aren t necessarily more likely

More information

Student-Athlete Insurance Information Form PLEASE INCLUDE A COPY OF YOUR INSURANCE CARD (BOTH SIDES)

Student-Athlete Insurance Information Form PLEASE INCLUDE A COPY OF YOUR INSURANCE CARD (BOTH SIDES) Student-Athlete Insurance Information Form PLEASE INCLUDE A COPY OF YOUR INSURANCE CARD (BOTH SIDES) PLEASE PRINT ALL INFORMATION CLEARLY AND COMPLETELY! Student-Athlete s Name: SS# - - DOB / /19 (mm/dd/year)

More information

ST. MARY S UNIVERISTY-ATHLETIC TRAINING Athletic Insurance Coverage

ST. MARY S UNIVERISTY-ATHLETIC TRAINING Athletic Insurance Coverage ST. MARY S UNIVERISTY-ATHLETIC TRAINING Athletic Insurance Coverage This information has been compiled and handed to you to help give you a better understanding of your son s/daughter s coverage while

More information

IU Sports Medicine Information Sheet

IU Sports Medicine Information Sheet IU Sports Medicine Information Sheet SPORTS MEDICINE PROGRAM A. MEDICAL SERVICES The sports medicine program at Indiana University works under the direct supervision of the team physician who is located

More information

STUDENT-ATHLETE DRUG EDUCATION AND TESTING POLICY

STUDENT-ATHLETE DRUG EDUCATION AND TESTING POLICY STUDENT-ATHLETE DRUG EDUCATION AND TESTING POLICY I. INTRODUCTION. The overall goal of Rogers State University's Student-Athlete Drug Education and Testing Policy is to promote a year-round drug free environment

More information

UNIVERSITY OF THE INCARNATE WORD SPORTS MEDICINE DEPARTMENT

UNIVERSITY OF THE INCARNATE WORD SPORTS MEDICINE DEPARTMENT UNIVERSITY OF THE INCARNATE WORD SPORTS MEDICINE DEPARTMENT Release and Waiver of Liability, Assumption of Risk, Indemnity and Hold Harmless Agreements The signed student-athlete is enrolled at the University

More information

BOSTON UNIVERSITY DEPARTMENT OF ATHLETICS DRUG TESTING AND EDUCATION POLICY

BOSTON UNIVERSITY DEPARTMENT OF ATHLETICS DRUG TESTING AND EDUCATION POLICY BOSTON UNIVERSITY DEPARTMENT OF ATHLETICS DRUG TESTING AND EDUCATION POLICY Boston University supports the National Collegiate Athletics Association s policy regarding alcohol abuse and the use of banned

More information

Purchase College, SUNY Division of Physical Education, Recreation and Athletics

Purchase College, SUNY Division of Physical Education, Recreation and Athletics TABLE Chris OF Bisignano- CONTENTS Director of Athletics Bobby Ciafardini- S.I.D./N.C.A.A. Compliance Coordinator Purchase College, SUNY Division of Physical Education, Recreation and Athletics STUDENT-ATHLETE

More information

UNIVERSITY OF NEW HAVEN DEPARTMENT OF ATHLETICS Alcohol, Tobacco, and Other Drugs Substance Abuse Policy (ATOD)

UNIVERSITY OF NEW HAVEN DEPARTMENT OF ATHLETICS Alcohol, Tobacco, and Other Drugs Substance Abuse Policy (ATOD) UNIVERSITY OF NEW HAVEN DEPARTMENT OF ATHLETICS Alcohol, Tobacco, and Other Drugs Substance Abuse Policy (ATOD) The University of New Haven Department of Athletics substance abuse policy is founded in

More information

Optional Student Athlete Drug Testing Programs

Optional Student Athlete Drug Testing Programs Page 1 Optional Student Athlete Drug Testing Programs The Board of Education authorizes individual PCS schools to implement a drug testing program for student athletes. However, individual PCS schools

More information

Oregon Coast Community College. Medical Assistant Program Handbook

Oregon Coast Community College. Medical Assistant Program Handbook Oregon Coast Community College Medical Assistant Program Handbook 2014-2015 Table of Contents I. Medical Assistant Training Program Objectives/Outcomes Policy 2 II. Program Description and Prerequisites

More information

UCF Athletics Association Inc., Sports Medicine Substance Abuse Policy

UCF Athletics Association Inc., Sports Medicine Substance Abuse Policy UCF Athletics Association, Inc.,( UCFAA, Inc. ) recognizes that the use of certain drugs, legal or illegal, is not in the best interests of the student athlete or the UCFAA, Inc. It is the policy of the

More information

McGill Sport Medicine Clinic Level 1&2 Varsity Costs, Services, Coverage (Revised June 26, 2010)

McGill Sport Medicine Clinic Level 1&2 Varsity Costs, Services, Coverage (Revised June 26, 2010) McGill Sport Medicine Clinic Level 1&2 Varsity Costs, Services, Coverage (Revised June 26, 2010) 1. Philosophy Athletics and Recreation is committed to providing men s & women s basketball, cross country,

More information

Medical Insurance Information for Stanford Student-Athletes 2012-2013

Medical Insurance Information for Stanford Student-Athletes 2012-2013 Medical Insurance Information for Stanford Student-Athletes 2012-2013 Understanding medical insurance and the costs associated with your medical treatment is very important. Please read this carefully.

More information

Role of the Athletic Trainers:

Role of the Athletic Trainers: Role of the Athletic Trainers: Athletic trainers (ATC) are members of the allied health community, are certified by the National Athletic Trainers Board of Certification, licensed in the state of Ohio,

More information

AN ACT REQUIRING FULL DISCLOSURE TO PROSPECTIVE ATHLETES BEING RECRUITED TO INSTITUTIONS OF HIGHER EDUCATION.

AN ACT REQUIRING FULL DISCLOSURE TO PROSPECTIVE ATHLETES BEING RECRUITED TO INSTITUTIONS OF HIGHER EDUCATION. AN ACT REQUIRING FULL DISCLOSURE TO PROSPECTIVE ATHLETES BEING RECRUITED TO INSTITUTIONS OF HIGHER EDUCATION. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section

More information

Portland State University Sports Medicine Returning Student Athlete Health Report Form

Portland State University Sports Medicine Returning Student Athlete Health Report Form Portland State University Sports Medicine Returning Student Athlete Health Report Form All the following forms must be completed and submitted to the Sports Medicine Department annually. It needs to be

More information

POLICY TO ADDRESS SUSPECTED SPORTS RELATED HEAD INJURY/CONCUSSION

POLICY TO ADDRESS SUSPECTED SPORTS RELATED HEAD INJURY/CONCUSSION POLICY TO ADDRESS SUSPECTED SPORTS RELATED HEAD INJURY/CONCUSSION The Easton Public Schools has adopted this policy to address the identification and proper handling of suspected head injury for students

More information

Dear Potomac State College Student Athletes and Parents:

Dear Potomac State College Student Athletes and Parents: Dear Potomac State College Student Athletes and Parents: We are please to have your son/daughter as a student athlete at Potomac State College of West Virginia University and hope that he/she will achieve

More information

NON CERTIFIED PERSONNEL POSITION AVAILABLE

NON CERTIFIED PERSONNEL POSITION AVAILABLE Hickman Mills C-1 School District 9000 Old Santa Fe Rd. 816-316-9572 PLEASE POST NON CERTIFIED PERSONNEL POSITION AVAILABLE OPEN: AUGUST 18, 2010 CLOSING: AUGUST 24, 2010 ATHLETIC TRAINER Full time Monday

More information

Center for Intercollegiate Athletics Rochester Institute of Technology Student-Athlete Alcohol and Other Drugs Education and Testing Program

Center for Intercollegiate Athletics Rochester Institute of Technology Student-Athlete Alcohol and Other Drugs Education and Testing Program Center for Intercollegiate Athletics Rochester Institute of Technology Student-Athlete Alcohol and Other Drugs Education and Testing Program I. Introduction The Center for Intercollegiate Athletics ( Athletics

More information

Rockwood Summit High School Student Athletic Training Program. Prepared by: Jen Glazer, ATC

Rockwood Summit High School Student Athletic Training Program. Prepared by: Jen Glazer, ATC Rockwood Summit High School Student Athletic Training Program Presented by: Jen Glazer, ATC/L 1 Revised: Aug. 4, 2009 Dear Parent/Guardian, Your child has expressed interest in becoming a student athletic

More information

MEMO: Athletic Participation

MEMO: Athletic Participation Athletic Training MEMO: Athletic Participation TO: DATE: FROM: All Varsity Student-Athletes and Parents For the 2007-2008 Academic Year Michael DeSavage, Head Athletic Trainer NEW Athletes & TRANSFERS

More information

REGISTRATION FORM. How would you like to receive health information? Electronic Paper In Person. Daytime Phone Preferred.

REGISTRATION FORM. How would you like to receive health information? Electronic Paper In Person. Daytime Phone Preferred. Signature Preferred Pharmacy Referral Info Emergency Contact Guarantor Information Patient Information Name (Last, First, MI) REGISTRATION FORM Today's Date Street Address City State Zip Gender M F SSN

More information

2014/15 STUDENT-ATHLETE SPORTS PHYSICAL PACKET

2014/15 STUDENT-ATHLETE SPORTS PHYSICAL PACKET 2014/15 STUDENT-ATHLETE SPORTS PHYSICAL PACKET Athlete Information Form Please complete entire form Athlete Name: Athlete Cell: Sex: M F Age: Graduation Year: Sport(s): Allergies: Medications: Emergency

More information

2015 Annual Patient Paperwork Update for Existing Patients

2015 Annual Patient Paperwork Update for Existing Patients 2015 Annual Patient Paperwork Update for Existing Patients DATE: ͺͺͺͺ ŚĞĐŬ WƌĞĨĞƌƌĞĚ ůŝŷŝđ &ƚ tăljŷğ 'ƌğğŷǁžžě

More information

All forms are to be completed and returned to: The University of Denver Attn: Sports Medicine, Room 1312 2201 E. Asbury Ave. Denver, CO 80208-3200

All forms are to be completed and returned to: The University of Denver Attn: Sports Medicine, Room 1312 2201 E. Asbury Ave. Denver, CO 80208-3200 Julie Campbell Director of Sports Medicine (303) 871-3918 Office (303) 871-3666 Fax jcampbel@du.edu To: Re: Returning Student-Athletes 2014-2015 Sports Medicine Medical Information Packets Date: Thursday,

More information

18.4.11 Intercollegiate Athletics Drug Education, Testing and Counseling Program

18.4.11 Intercollegiate Athletics Drug Education, Testing and Counseling Program Policies of the University of North Texas 18.4.11 Intercollegiate Athletics Drug Education, Testing and Counseling Program Chapter 7 Student Affairs Policy Statement. The Administration of the University

More information

Stanford University Club Sports Athletic Training Services Manual

Stanford University Club Sports Athletic Training Services Manual Stanford University Club Sports Athletic Training Services Manual Preface The purpose of this manual is to provide the athletic trainer, coaches, and club sport athletes with guidelines as to how athletic

More information

Saint Joseph s University Department of Athletics Drug and Alcohol Education & Testing Program

Saint Joseph s University Department of Athletics Drug and Alcohol Education & Testing Program Saint Joseph s University Department of Athletics Drug and Alcohol Education & Testing Program 1. Introduction The following policy statement has been adopted and shall be administered by the Saint Joseph

More information

Truett-McConnell Athletic Training Forms

Truett-McConnell Athletic Training Forms Truett-McConnell Athletic Training Forms Table of contents 1. Welcome letter 2. Assumption of Risk and Consent to Treat 3. Authorization/Consent for Disclosure of Protected Health Information (PHI) 4.

More information

Departmental Records Retention Schedule

Departmental Records Retention Schedule University of Washington Page 1 of 8 Departmental Records Schedule 1 Athlete X-Rays - Prior to 1999-DISCONTINUED OPR Last Contact 12Y 99-06-59190 Provides record of x-rays taken for injured athletes. Prior

More information

CATASTROPHIC INCIDENT PLAN. Revised July 2010

CATASTROPHIC INCIDENT PLAN. Revised July 2010 CATASTROPHIC INCIDENT PLAN Revised July 2010 1 TABLE OF CONTENTS DEFINITION OF A CATASTROPHIC INJURY 3 MANAGEMENT TEAM 3 IMMEDIATE ACTION PLAN 3 CHAIN OF COMMAND/ROLE DELINEATION 3 CRIMINAL CIRCUMSTANCES

More information

Concussion Information Sheet

Concussion Information Sheet Concussion Information Sheet A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force

More information

NCAA CATASTROPHIC INJURY INSURANCE PROGRAM FREQUENTLY ASKED QUESTIONS

NCAA CATASTROPHIC INJURY INSURANCE PROGRAM FREQUENTLY ASKED QUESTIONS NCAA CATASTROPHIC INJURY INSURANCE PROGRAM FREQUENTLY ASKED QUESTIONS APPLICABLE TO 8/1/12 TO 7/31/13 POLICY PERIOD This document is a summary of the NCAA Catastrophic Injury Insurance Program. The insurance

More information

Conroe Physician Associates. Patient Consent Form. I fully understand that this is given in advance of any specific diagnosis or treatment.

Conroe Physician Associates. Patient Consent Form. I fully understand that this is given in advance of any specific diagnosis or treatment. Conroe Physician Associates Patient Consent Form Please Read and Sign I, undersigned, hereby consent to the following: Administration and performance of all treatments Administration of any needed anesthetics

More information

ATTENTION STUDENT-ATHLETE PARENT/GUARDIAN

ATTENTION STUDENT-ATHLETE PARENT/GUARDIAN ATTENTION STUDENT-ATHLETE PARENT/GUARDIAN All first-year and transfer students have two SEPARATE requirements: Requirement #1 is for ADMISSION to Shippensburg University (see checklist below). Requirement

More information

1. Pre-Participation Medical Clearance a. No athlete shall be eligible to participate in any sports unless:

1. Pre-Participation Medical Clearance a. No athlete shall be eligible to participate in any sports unless: Sports Medicine 2 1. MEDICAL STAFF The sports medicine staff consists of the Team Orthopedic Physician(s), the Assistant Director of Athletics for Sports Medicine, Certified Assistant Athletic Trainers,

More information

Warrior Sports Medicine

Warrior Sports Medicine Warrior Sports Medicine On behalf of Warrior Athletics we would like to welcome Student Athletes and their families to the 2013-2014 Academic Year. Please take the time to read this information so that

More information

Seattle University Athletic Training Room and Sports Medicine Department. Policy and Procedure Manual

Seattle University Athletic Training Room and Sports Medicine Department. Policy and Procedure Manual Seattle University Athletic Training Room and Sports Medicine Department Policy and Procedure Manual 06/2012 Policy and Procedure Table of Contents Mission Statement. 3 Athletic Training Room Staff Outline

More information

INSURANCE PROGRAM. Accidental Medical and Dental coverage Coverage. late fees. or

INSURANCE PROGRAM. Accidental Medical and Dental coverage Coverage. late fees. or Why As someone a high-risk do I else, need sport, being Hockey there injured Insurance? are HOCKEY while chances playing. of you or INSURANCE PROGRAM CARHA player injure someone. on Hockey player provides

More information

Pre-Participation Physical Evaluation

Pre-Participation Physical Evaluation 1 Dear Returning YHC Student-Athlete and Parents/Guardians, As a Young Harris College student-athlete, we certainly hope that medical treatment for a serious injury is not necessary, but in the event that

More information

SOUTHEASTERN OKLAHOMA STATE UNIVERSITY. ALCOHOL, TOBACCO, and OTHER DRUG-EDUCATION GUIDELINES. and the. DRUG-TESTING PROGRAM for STUDENT-ATHLETES

SOUTHEASTERN OKLAHOMA STATE UNIVERSITY. ALCOHOL, TOBACCO, and OTHER DRUG-EDUCATION GUIDELINES. and the. DRUG-TESTING PROGRAM for STUDENT-ATHLETES SOUTHEASTERN OKLAHOMA STATE UNIVERSITY ALCOHOL, TOBACCO, and OTHER DRUG-EDUCATION GUIDELINES and the DRUG-TESTING PROGRAM for STUDENT-ATHLETES Student-athletes are responsible for anything they ingest.

More information

BLINN COLLEGE ADMINISTRATIVE POLICY/PROCEDURE MANUAL

BLINN COLLEGE ADMINISTRATIVE POLICY/PROCEDURE MANUAL BLINN COLLEGE ADMINISTRATIVE POLICY/PROCEDURE MANUAL SUBJECT: Athletic Department Drug EFFECTIVE DATE: 9-14-10 Testing Policy and Procedure REVISION DATE: 8-28-12 The Blinn College Administration and the

More information

LAST NAME FIRST NAME MI BIRTHDATE ADDRESS CITY STATE ZIP HOME PHONE# CELL# S.S. # EMAIL ADDRESS

LAST NAME FIRST NAME MI BIRTHDATE ADDRESS CITY STATE ZIP HOME PHONE# CELL# S.S. # EMAIL ADDRESS The more information we know about you and your family, the better medical care we can provide you. None of this information will be released to any person except with your written consent. LAST NAME FIRST

More information

HEAD INJURIES & CONCUSSION PREVENTION AND MANAGEMENT PROTOCOL

HEAD INJURIES & CONCUSSION PREVENTION AND MANAGEMENT PROTOCOL HEAD INJURIES & CONCUSSION PREVENTION AND MANAGEMENT PROTOCOL Policy Statement In order to effectively and consistently manage head injuries, the Brooke Charter School has established the following protocol

More information

You may opt to have your own personal physician perform the pre participation exam. OBU will not accept clearance from a

You may opt to have your own personal physician perform the pre participation exam. OBU will not accept clearance from a Oklahoma Baptist University Sports Medicine Injury and Illness Procedures The Sports Medicine Department is primarily responsible for the delivery of health care to all student athletes participating in

More information

Garrett Middle School Athletic Handbook 2015-16

Garrett Middle School Athletic Handbook 2015-16 Garrett Middle School Athletic Handbook 2015-16 1 Athletic Department Philosophy It is the intent of Garrett Middle School to encourage and allow athletic participation while maintaining academic integrity

More information

David A. Wang, MD Primary Care Sports Medicine Physician PRINT NAME: ADDRESS: DOB: AGE: SEX: SS# HOME: MOBILE PHONE: WORK: FAX:

David A. Wang, MD Primary Care Sports Medicine Physician PRINT NAME: ADDRESS: DOB: AGE: SEX: SS# HOME: MOBILE PHONE: WORK: FAX: David A. Wang, MD Primary Care Sports Medicine Physician PRINT NAME: ADDRESS: DOB: AGE: SEX: SS# HOME: MOBILE PHONE: WORK: FAX: INSURANCE INFORMATION Did you injure yourself at work or is this injury a

More information

Chapter 2: Organizing and Administering an Athletic Health Care Program. 2007 McGraw-Hill Higher Education. All rights reserved.

Chapter 2: Organizing and Administering an Athletic Health Care Program. 2007 McGraw-Hill Higher Education. All rights reserved. Chapter 2: Organizing and Administering an Athletic Health Care Program Rules of Operation for an Athletic Healthcare Program Must develop policies and procedures Delineate daily routine of program Define

More information