PHYSICAL SCREENING PACKET

Attention Student-Athletes:

In order to be cleared by the athletic training staff to participate in any practices or contests, ALL athletes must have the following forms completed and returned directly to the Athletic Training Room (41-121A).

Please read the forms carefully.

 Student-Athlete Checklist

 

 Physical Screening Examination - must include Dr. stamp and signature
Physical must be done by an M.D., D.O., P.A., or Nurse Practitioner per CCCAA

 

 Insurance Verification Form - must complete with signature

 

 Emergency Care Card - this is to be filled out by anyone traveling with an athletic team (players, coaches, managers etc.)

 

 Liability Waiver Form - include sport at the top and signature

  

 Concussion Information and Acknowledgement - signature

  

NOTE: Student-athletes under the age of 18 must have a parent signature on all forms