Davidson College Sports Medicine Football New Athlete Pre-Participation Letter

Transcription

1 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 you in regards to any medical needs that may arise during your intercollegiate athletic participation. This document contains multiple steps that need to be completed by you, the athlete, and your parent/guardian before you will be medically cleared to participate in any and all practices, games, performance testing, and strength and conditioning sessions. It is your responsibility to complete everything listed in this document in order to assure you will be able to participate immediately when arriving to campus. If you have suffered an injury or other condition within the past year that has restricted you from participation in any sport please contact your team assigned athletic trainer to discuss if any additional paperwork is required. This may include doctor s notes, surgical notes, diagnostic testing reports, physical therapy notes and any other relevant information deemed necessary. The NCAA bans classes of drugs because they can harm student athletes and create an unfair advantage in competition. Some medications contain NCAA-banned substances, but are needed by student-athletes to support their academic needs or general health. Accordingly, the NCAA has a procedure to review and approve use of certain medications that contain NCAA-banned substances through a Medical Exemptions Procedure. If you are currently prescribed any medication, you must disclose this to the sports medicine staff and provide any related medical documentation. While you may still participate while using a prescribed banned substance, it is important to realize you may still test positive if randomly chosen to be drug tested. If this occurs, the sports medicine staff needs to have the proper paperwork on file to submit to the NCAA for an exemption. If you are unsure whether a medication you are currently taking is banned by the NCAA, please contact your team assigned athletic trainer for assistance. The sports medicine department utilizes Athletic Trainer System (ATS) which is an electronic medical records system. This allows us to electronically maintain all medical records as well as to document all athletic injuries that occur throughout your participate in athletics at Davidson College. This system also allows for you to enter your information into the system creating an athlete record for yourself. The following steps will help you navigate the system and provides the sports medicine staff with information necessary for your clearance to participate in Davidson athletics. It is important to complete all the steps and submit all information in order to guarantee no delays or restrictions in your participation once you arrive on campus. All incoming freshmen and transfer athletes are required to have a completed health physical on file at the Student Health Center before being allowed to participate in any team practices, games, performance testing, and training sessions. You will receive instructions from the health center sent directly to your . This physical is to be completed by your family physician at home and must be completed after Feb. 5 th. Please be aware that if you plan to attend the Immersion Camp in June, the health center physical must be completed prior to your attendance. The Davidson Sports Medicine staff will confirm completion of your physical with the Student Health Center, but your physical form is not to be submitted to the sports medicine staff. Your completed physical form is to be returned directly to the Student Health Center. If you have any questions in regard to your physical please contact the Student Health Center directly at

2 Davidson College Sports Medicine Pre-Participation Checklist Please use the checklist below to ensure that you have completed and submitted all necessary medical paperwork to the Davidson College Sports Medicine Department prior to your arrival on campus. Failure to complete and submit required paperwork will result in you being restricted from participating in any team activities including practices, games, performance testing, or training sessions. Please ensure all paperwork has been completed and submitted by the following dates to allow the sports medicine staff to review your information prior to your arrival on campus. Submitting paperwork after these dates may delay your participation in your sport. If you are attending the Immersion Camp June 10 th If you are not attending the Immersion Camp -- July 15 th Current Injuries/Previous Surgery Information Dr. Notes, Surgical Notes, MRI reports, etc. Insurance Information Submit a hard copy of the front and back of your insurance card Emergency Contact Information Pre-Participation Questionnaire Orthopedic Health History Form Agreement to Disclose Injuries and Illnesses Form Drug Testing Notification Form Prescription Medication Release Authorization Form Supplement Notification Form Peculiarities of Insurance Coverage Form Football Acceptance of Risk/Liability Waiver Concussion Education Medical Policy (sign and return hard copy) ADHD Medical Exemption Form (if necessary) Sickle Cell Testing Verification Student Health Center Physical

3 Getting Started With ATS **Note DO NOT USE Internet Explorer** ATS does not operate correctly using the Internet explorer web browser. Open your internet browser (Firefox, Chrome, Safari), clear the address bar, and type in davidson2.atsusers.com. The ATS Web Portal Login Screen will appear and the database, ats_davidson, should already be filled in. Enter the word new in the Athlete ID box and the password box and click Login. **If you are timed out from the system due to inactivity you must retype the entire web address and log back in using your ID and password that you create. Please do not use the refresh button as you will not be able to access the database.

4 When you are logged in you will need to complete any and all information described in the following directions. General Select your sport from the Team 1 drop down list (if you are a multi-sport athlete repeat for Team 2 and Team 3) Please complete all of the required fields highlighted in yellow. Fields not highlighted in yellow are optional. In the name fields please enter your legal first and last name. Do not enter any nicknames. Use your Davidson College address in the field. If you have not been issued your Davidson address please use the address you use most frequently. The address highlighted in yellow should be your address while at home and the optional address should be the address where you will receive mail while attending Davidson. Change your athlete ID to match your student ID number. Please enter your ID number starting with 801. Leave the Alternate ID field blank. Change your password to a password of your choosing. Be sure to remember this password as you will need it to sign back into the ATS system each year to update your information. Please choose Freshman as your year from the dropdown box.

5 Please leave the Driver s #, Passport #, Race, and Ethnicity boxes blank Please use the dropdown lists if you have any medical alerts, allergies, or medications you are currently taking. If an option is not listed please type it in the yellow box. If you have no medical alerts, allergies, or medications to report please type none in each box. Once you have entered all the required information please click the insurance tab at the top of the screen to enter your insurance information. **You will not be able to save your information until you have completed all required information under the General, Insurance, and Contact tabs. It is important for you to remember your athlete ID and password. You will be required to use this information every time you do therapy or get treatment in the athletic training room. You will also need it when you update your paperwork every year. Insurance Choose your insurance company from the dropdown list. **If your insurance company is not listed in the dropdown box please click the button. In the box that appears type in the name of your insurance company and click the button. Your insurance company will now be available in the dropdown box. Please complete all the required fields highlighted in yellow. If you have a Group # please enter that as well. Please upload images of the front and back of your insurance card. You will also be required to submit a hard copy of your insurance cards to keep on file as well. **Primary insurance coverage is mandatory for participation in athletics at Davidson College.

6 Please be aware that the student insurance plan offered through Davidson College does not meet the requirements of the Davidson Athletic Department as it does not provide coverage for injuries sustained as a result of participation in intercollegiate athletics. If you choose to purchase the Davidson student insurance plan you will also be required to provide proof of additional insurance coverage that provides coverage for intercollegiate athletics. Contacts Complete all required fields highlighted in yellow. You may also enter information in the other fields, but it is not required. After you have entered all necessary information click the button to save your information. **YOU MUST INCLUDE INFORMATION FOR ATLEAST 1 EMERGENCY CONTACT PERSON. After you click the save button you will now have access to the following tabs to enter further information. Medical History Tab Please enter any and all surgical procedures you have had in your lifetime. Click on the left hand side of the screen next to the word Surgeries. Please complete each field highlighted in yellow. In the Therapy Completed field enter the date when you were cleared by your doctor to return to participation in your sport. (If you have not been cleared please type not cleared ). In the Hospital & City field enter the physician s practice and where the procedure occurred. Click the button to save. Repeat this process if necessary with any other surgeries

7 After you have updated any changes please click. Paperwork Tab **You are not required to complete any paperwork or input any information under this tab. Insurance Tab If you have secondary insurance coverage in addition to the plan you previously entered please enter it at this time. Please click the button and complete all information for the secondary insurance coverage. Please type 2 in the payor# field for any secondary insurance coverage. **If you do not have any secondary insurance policies you do not need to complete any further insurance information. Contacts If you would like to add additional emergency contacts please enter them at this time. Please click the button and complete all information for any additional emergency contacts. **If you do not have any additional emergency contact information to add you do not need to complete any further information.

8 Forms: Pre-Participation Questionnaire Click the dropdown arrow in the Form Name box, select the Pre-Participation Questionnaire form and click the button to the right. Please read through each and every question. You must record an answer for every question. Choose Yes or No for every question requiring this type of answer. For questions where a Yes or No answer is not available you are required to type your answer in the Explain box below the question. Not all questions will require an explanation, but for any question that contains an Explain box you must provide an explanation if you answer the question with a Yes. Please be aware that there are 8 pages to this questionnaire. In order to switch between pages click the down arrow in the Page box at the bottom of the screen and complete each page. Please sign your name using your mouse or trackpad in the athlete/student signature box and type your first and last name in the Signed By box directly below the signature box and click the button to save your signature. Your parent/guardian must complete the Parent/Guardian Signature box with their signature as well. **A timestamp will be visible in the signature box when your signature is saved** Once you have answered every question and saved your signatures click the button at the bottom of the screen.

9 Orthopedic Health History **This form will not save until you have answered every question** Click the dropdown arrow in the Form Name box, select the Orthopedic Health History form and click the button to the right. Click the arrow in the dropdown box and choose the sport you will be participating in. Please read through and answer each and every question in the same manner that you completed the Pre-Participation Questionnaire. There are 3 pages of questions that will need to be completed. After answering every question you and your parent/guardian must sign your names in the signature boxes and save them. Once you have answered every question and saved your signatures click the button at the bottom of the screen. Agreement to Disclose Injuries and Illnesses Click the dropdown arrow in the Form Name box, select the Agreement to Disclose Injuries and Illnesses form and click the button to the right. Please read the disclosure agreement statement and click the button to acknowledge your agreement. Click the arrow in the dropdown box and choose the sport you will be participating in. After completing both sections you and your parent/guardian must sign your names in the signature boxes and save them. After your signatures are saved in both boxes click the button at the bottom of the screen. Drug Testing Notification and Consent Click the dropdown arrow in the Form Name box, select the Drug Testing Notification and Consent form and click the button to the right. Please click on the link to review the Student Athlete Drug Education and Testing Policy. Please read each statement and click the button to acknowledge your agreement. After clicking for all the statements you and your parent/guardian must sign your names in the signature boxes and save them. After your signatures are saved in both boxes click the button at the bottom of the screen. Prescription Medication Release Authorization Click the dropdown arrow in the Form Name box, select the Prescription Medication Release Authorization form and click the button to the right. List any medications that you would like to the sports medicine staff to store for you in the event it is needed during a practice or competition.

10 After clicking for all the statements you and your parent/guardian must sign your names in the signature boxes and save them. After your signatures are saved in both boxes click the button at the bottom of the screen. Student Athlete Supplement Notification Click the dropdown arrow in the Form Name box, select the Student Athlete Supplement Notification form and click the button to the right. For the first question please choose either, Yes or No and complete the Explain box as directed. For the second question please click on the link to the Davidson College Department of Athletics Supplement Policy and read through the policy. After reading the policy keep a copy of the policy for your personal records and click the button to confirm you have read and understand the policy. Read each of the remaining statements and click the button to confirm your understanding and agreement with each statement. After clicking for all the statements you and your parent/guardian must sign your names in the signature boxes and save them. After your signatures are saved in both boxes click the button at the bottom of the screen. Peculiarities of Insurance Coverage Click the dropdown arrow in the Form Name box, select the Peculiarities of Insurance Coverage form and click the button to the right. Please read each question and choose either Yes or No as it pertains to your personal insurance policy. After choosing Yes or No for every question you and your parent/guardian must sign your names in the signature boxes and save them. After your signatures are saved in both boxes click the button at the bottom of the screen. Football Acceptance of Risk/Liability Waiver Click the dropdown arrow in the Form Name box, select the Football Acceptance of Risk/Liability Waiver form and click the button to the right. Please read each statement carefully and click the button to acknowledge your agreement. After choosing Yes for every statement, you and your parent/guardian must sign your names in the signature boxes and save them. After your signatures are saved click the button at the bottom of the screen. ** Please complete only the Football Acceptance of Risk/Liability Form.

11 Concussion Education Click the dropdown arrow in the Form Name box, select the Concussion Education form and click the button to the right. Please click on the links provided to review the NCAA Concussion Video, the NCAA Concussion Fact Sheet, and the Davidson College Sports Medicine Concussion Policy. Acknowledge that you have reviewed the video, fact sheet, and concussion policy by clicking the button. After clicking Yes you and your parent/guardian must sign your names in the signature boxes and save them. After your signatures are saved click the button at the bottom of the screen. efiles Medical Policy Click on the button on the right side of the window. Please read the Davidson Medical Policy in its entirety and keep a copy for your personal records. Print and sign the last page of the medical policy and return a hard copy with your signature and your parent s signature to the Davidson sports medicine staff. ** The last page must be completed and submitted to the sports medicine staff before you will be allowed to participate in any team training or practice sessions. ADHD Medical Exemption **If you are not diagnosed with ADHD you do not need to complete this section If you have been diagnosed with ADHD and have been prescribed medication for the condition please read and review this document explaining the procedures to seek a medical exception for the use of a banned substance. ADHD Reporting Form: If you are currently diagnosed and being treated for ADHD you are required to print the ADHD Reporting Form which is the last page of the ADHD medical exemption document. This form must be completed by your treating physician and submitted to the Davidson sports medicine department with all supporting documentation as described within the reporting form.

12 **Failure to provide all required information may result in a positive drug test should you be chosen for drug testing while participating in Davidson athletics. Sickle Cell Testing Letter Every student athlete participating in intercollegiate athletics is required to submit proof of their sickle cell status as mandated by the NCAA. Please review the Sickle Cell Testing Letter with instructions on how to obtain proof of your sickle cell status. **Failure to submit proof of testing to the Davidson Sports Medicine staff will disqualify you from being able to participate in any practices, games, performance testing, or training sessions. *All electronically completed forms can be viewed at the bottom of the screen under the efiles tab. **Double check to ensure that all information and forms are complete. Incomplete information will delay your participation in your sport. Please mail or fax hard copies of the signed Medical Policy, Insurance Card, and Sickle Cell Verification to the following: Davidson College Sports Medicine Dept. PO BOX 7158 Davidson, NC FAX #: Additional resources can be located in the sports medicine section of the Davidson athletics website. ( If you have any questions or concerns about how to complete or submit your medical paperwork please contact Beth Hayford or Dathan Zabel by either or at the numbers listed below. Beth Hayford, LAT, ATC, Assistant Athletic Director for Sports Medicine behayford@davidson.edu Dathan Zabel, MS, LAT, ATC, Assistant Athletic Trainer dazabel@davidson.edu