- Screenings have been scheduled for you and your teammates once you arrive on campus.
- In preparation for this screening you MUST complete a series of documents prior to 7/30/2017.
- Below is a brief description of the documents you must complete.
- Read over each description, as well as the directions which follow, to ensure you complete all documents.
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 licensed 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.
On-Line Insurance Enrollment/Waiver - 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. (Please Note; Detailed information on this secondary policy can be found at the bottom of this text section - SEE "Policy Statement For Athletic Insurance). To facilitate prompt care and effective communication with medical/insurance providers, you must complete the posted (On-Line Insurance Enrollment/Waiver Document) form 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.
- Policy Statement For Athletic Insurance - Download and keep this form. It explains the policy of the Ursinus College Athletic Accident Insurance.
Medical Consent - All students must complete and submit this document to be eligible to receive their pre-season screening.
Authorization for Release (HIPAA Policy) - Completion of this document authorizes Ursinus College Licensed Athletic Trainers to release injury information.
A notice to FRESHMEN/TRANSFER Student Athletes: All student athletes new to Ursinus College (class of 2021 and transfer student athletes) will have two additional requirements to complete.
- These students must complete the Ursinus College Confidential Health Record with the assistance of their primary care physician, and return this completed form to the Ursinus Wellness Center. This form is handed out during the New Student Orientation Program. However, a replacement copy is posted here (Ursinus College Confidential Health Record) for your convenience. Once completed by your doctor this form should be returned to the UC Wellness Center (before 7/30/17). Return instructions are on the form.
- The NCAA requires that all student athletes have knowledge of their sickle cell trait status, and provide proof of this knowledge to Ursinus College. Proof can be documented by; 1) having your primary care physician complete “Item H” on the Ursinus College Confidential Health Record, 2) providing laboratory results of testing, OR 3) completing the Ursinus College Sickle Cell Trait Form for NCAA Intercollegiate Athletics. Further information can be found under the "Misc. Forms" tab on this site, or by using the links in the form itself.
Completing Documents; Student athletes UNDER 18.
Now that you have gained an understanding of the documents you are required to complete in preparation for your preparticipation medical screening, you must use the links below to obtain the required documents for completion.
- Since some forms require the signature of a parent/guardian, these documents (links directly below) 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.
HIPAA Policy NCAA Sickle Cell Information/Waiver Referral Form (Treating PHYSICIAN completes ONLY for cases of significant illness/injury in the last 5 years.) Completed forms can be returned to: URSINUS COLLEGE ATHLETIC TRAINING Attn., Dana Roche - Athletics P.O. Box 1000 Collegeville, PA 19426
- Since the On-Line Insurance Enrollment/Waiver Document does NOT require the signature of a parent/guardian, it can be completed on-line. Click here , or use the link of the same name above to access this document.
Trouble Shooting On-Line Form Use:
Should problems arise, try;
- Using Internet Explorer
- Logging in using only your username - (omit @ ursinus.edu while logging on).
HOWEVER If you are still experiencing difficulty with any of the following;
- Difficulty obtaining Adobe Reader.
- Trouble opening the Adobe files provided.
- Following the links provided above ("here").
- Opening/Completing the required on-line forms.
Please contact Ursinus College "Tech Support" by phone at (610) 409-3789 to obtain assistance.