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This is the home of the Ursinus College Athletic Training Department. On this page, you will find contact information for all of our certified athletic trainers, as well as required forms that new and or returning student-athletes need to fill out.
Mission
Athletic Training Staff Contact Information
Pam Chlad, M.Ed., RN, ATC
610-409-3104
Sports: Football, Gymnastics, Men’s and Women’s Golf
Assistant Athletic Trainers:
Kathy Wright, Ed.D., ATC
610-409-3498
Sports: Men’s Soccer, Men’s and Women’s Tennis
Michelle Vande Berg, M.S., ATC, CSCS
610-409-3024
Sports: Field Hockey, Men’s and Women’s Swimming, Women’s Basketball, Baseball
Akinori Kashiwagi, M.A., ATC
610-409-3371
Sports: Football, Men’s and Women’s Indoor Track, Men’s Lacrosse
Colin Dixon, M.S., ATC
610-409-3477
Sports: Volleyball, Women’s Cross Country, Men’s Basketball, Men’s and Women’s Indoor Track, Women’s Lacrosse
Jeffrey Wolfe, M.S., ATC, ROT
610-409-3610
Sports: Women’s Soccer, Men’s Cross Country, Wrestling, Softball, Men’s and Women’s Track & Field
Chris McGuigan, B.S., ATC
610-409-3610
Sports: Men’s and Women’s Swimming, Men’s and Women’s Indoor Track, Men’s and Women’s Track & Field
Team Physicians:
Dr. Gary Canner, M.D.
Berkshire Orthopedics
Wyomissing, PA 19610
Dr. Paul Doghramji, M.D.
UC Wellness Medical Director
Ursinus College Wellness Center
Preparticipation Physical Evaluation - The student
athlete is required to answer the survey questions with honesty and
to their best ability in order to pass accurate information on to
the UC medical staff. Submitting a complete and correct
medical history will greatly ease the pre-season screening process
when these questions are reviewed with your certified athletic
trainer. You will not be allowed to receive
your pre-season screening without completing this survey, and
all athletes must pass this screening before beginning
sport participation.
Insurance Information - The injured student-athlete is sometimes referred by the Ursinus College Sports Medicine Team to outside medical facilities. In the event of referral to an outside facility your personal health insurance is used as primary payment, with Ursinus College providing a secondary insurance policy for official athletic injury cases. To facilitate prompt care and effective communication with medical/insurance providers, you must complete the posted document providing information about your current personal health care plan.
- Student-athletes and their families are required to access this document as needed to update insurance information each and every time a change in coverage/policy occurs.
- Student-athletes are required to have their personal insurance card, or copy, on campus at all times.
- The student-athlete will be required to bring this card/copy with them to their team’s Pre-Season Athletic Physicals.
- The student-athlete should be prepared to produce this card as needed throughout the school year in order to facilitate referral for off-campus care.
Medical Consent - All students must complete and submit this
document to be eligible to receive their pre-season screening.
Authorization for Release - Completion of this document authorizes Ursinus College Certified Athletic Trainers to release injury information.
Policy For Athletic Insurance - Please download
and keep this form. It explains the policy of the Ursinus College
Athletic Accident Insurance.
STUDENT-ATHLETES who are 18 years, or older can click here to
access the required documents for completion.
STUDENT-ATHLETES UNDER the age of 18, must use the links
below to access the required documents for completion. Please note;
only the "INSURANCE INFORMATION" document may be submitted on-line.
Since all of the remaining forms require the signature of a
parent/guardian, each document must be downloaded, printed, and
completed in full before being mailed to Ursinus Athletics as
directed below.
Note: You will need Adobe Reader to read and print out these
forms. If you do not have Adobe Reader, please download it here.
ALL FORMS CAN BE RETURNED TO: URSINUS COLLEGE, ATHLETIC
DEPARTMENT, ATTN: MONICA GIANCARLO, P.O. BOX 1000,
COLLEGEVILLE, PA 19426.
Preparticipation Physical Evaluation
Insurance Information
Medical Consent
HIPPA Policy






