College of Mount St. Joseph Student/Athletes Pre-Participation Physical Exams for the 2012/2013 school year.

Harrington Center Athletic Training Room

Saturday, August 11, 2012--Football

1:00pm: All returning football athletes
2:00pm: All new football athletes

Saturday, August 18, 2012—Fall Sports

8:30am: All new Male athletes

9:00am: All new Female athletes

9:30am: All returning Male athletes

10:00am: All returning Female athletes

Saturday, August 25, 2012—Winter and Spring Sports

8:30am: All new Female athletes

9:00am: All new Male athletes

10:00am: All returning Female athletes

10:30am: All returning Male athletes

If you are not able to attend your assigned date, you must attend one of the other two physical dates.  Please contact your Athletic Trainer to let them know of any changes.  Failure to attend one of the three physical dates will result in the inability to participate until January 2013.

ALL STUDENT-ATHLETES MUST PRINT AND COMPLETE THESE FORMS PRIOR TO ARRIVING AT THEIR SCHEDULED TIME FOR PHYSICALS. COPIES WILL NOT BE PROVIDED AT THE TIME OF PHYSICALS!  Please click on the name of the form to have it open up.

Any student-athlete without completed paperwork will not be permitted to complete a physical at their assigned time and may risk losing the ability to participate at the start of their sport season.

FRESHMEN AND OTHER FIRST-TIME PARTICIPANTS MUST COMPLETE:

1. Medical History form—Please be as complete and accurate as possible.

2. ADHD Form/Checklist—Only student-athletes who are currently taking prescription medication for ADD/ADHD need to complete this paperwork. The NCAA has developed a strict drug testing policy regarding ADHD medications. All ADHD medications are banned by the NCAA. In order to challenge this policy, this form must be completed, yearly, with all attachments, prior to your physical at the Mount. Please refer to the ADHD policy for more information, which can be found on the Coaches Corner section of the Sports Medicine website.

3. Personal Information form

4. Concussion Statement—Please read the NCAA Concussion fact sheet for Student-Athletes prior to completing this form.

5. Risk Waiver form

6. Handbook Signature Page—This should be completed after reading the on-line Student-Athlete Athletic Training Handbook, located in the Coaches Corner section of the Sports Medicine website.

7. Medical Release form

8. Privacy Practice form

9. Insurance Information form—Please complete so we may expedite the scheduling of physician appointments for our student-athletes. Please include a copy of all insurance cards, front and back, with the completed form. The College of Mount Saint Joseph carries a secondary athletic accident insurance policy. Please see the Student-Athlete Athletic Training Handbook for more information regarding our secondary insurance policy.

10. Insurance HIPAA—This form will permit us to release medical information to our secondary insurance carrier should an injury occur and documentation of the injury is requested by the insurance carrier in order to process bill payment.

11. NCAA HIPAA—Allows the College of Mount Saint Joseph to release health information to the NCAA, if required.

ALL RETURNING STUDENT-ATHLETES MUST COMPLETE:

1. Medical History Update form—Please be as complete and accurate as possible.

2. ADHD Form/Checklist— Only student-athletes who are currently taking prescription medication for ADD/ADHD need to complete this paperwork. The NCAA has developed a strict drug testing policy regarding ADHD medications. All ADHD medications are banned by the NCAA. In order to challenge this policy, this form must be completed, yearly, with all attachments, prior to your physical at the Mount. Please refer to the ADHD policy for more information, which can be found on the Coaches Corner section of the Sports Medicine website.

3. Personal Information form

4. Concussion Statement—Please read the NCAA Concussion fact sheet for Student-Athletes prior to completing this form.

5. Risk Waiver form

6. Handbook Signature Page—This should be completed after reading the on-line Student-Athlete Athletic Training Handbook, located in the Coaches Corner section of the Sports Medicine website.

7. Insurance Information form—Please complete so we may expedite the scheduling of physician appointments for our student-athletes. Please include a copy of all insurance cards, front and back, with the completed form. The College of Mount Saint Joseph carries a secondary athletic accident insurance policy. Please see the Student-Athlete Athletic Training Handbook for more information regarding our secondary insurance policy

8. Insurance HIPAA—This form will permit us to release medical information to our   secondary insurance carrier should an injury occur and documentation of the injury is requested by the insurance carrier in order to process bill payment.

9. NCAA HIPAA—Allows the College of Mount Saint Joseph to release health   information to the NCAA, if required

Additionally, if you have had any major injuries and/or illnesses within the last two years, it is required that you obtain and forward, to the following address, all records (x-ray, MRI, doctor, hospital, physical therapy, surgery reports, office notes, etc) regarding the injury and/or illness. Doing so will make your pre-participation examination (PPE) a much smoother experience. PPEs are scheduled for August 11th for football, August 18th for all fall sports and August 25th for all winter and spring sports. PPEs are mandatory to be eligible for practices and competition. Please contact the Athletic Training or Athletic Departments for exact times. If you cannot attend one of the above dates, you must contact the Head Athletic Trainer.

Please return all information and completed forms to:

Pate Cagle

Head Athletic Trainer

College of Mount Saint Joseph

5701 Delhi Road

Cincinnati, OH  45233

Or, you may drop off your completed forms to the Athletic Training Room or Athletic Department at your leisure.

These forms are not substituted for other requirements (i.e. insurance, pre-admittance physical, etc) for registration at the College.

FAILURE TO COMPLETE ALL OF THE APPROPRIATE FORMS WILL PRECLUDE YOU FROM PARTICIPATION IN ATHLETICS AT THE COLLEGE OF MOUNT SAINT JOSEPH UNTIL THEY ARE COMPLETED.