Current/New Student Athletes

• The athlete and parents/guardians should review all medical paperwork carefully.
• Please review the NCAA Banned-Drug List. Keep this list for your own records and review it before taking any substance.
  
  
  • First Agency Inc. Parent/Guardian Insurance Form & First Agency Inc. Authorization Form: Please fill out all of the information requested. Please attach two copies of your insurance card(s) both front and back sides.
  • Athlete Medical History Form: Please fill out the form completely.  If you sustained an injury/illness please explain in detail and include the injury date (if you cannot remember indicate fall 1999, winter 2001, etc.)  If you answered “yes” to any question, please explain in detail.  Also, if you had surgery (i.e. ankle, knee, shoulder, back, etc.) please obtain surgical records from your physician and include them with this form. If you are currently under the care of a physician for an illness or current injury you must have a detailed clearance note, including any restrictions you may have, in order to participate in your sport.
  • SVSU Athletics Medical Policies and Procedures packet and Affidavit form:  Please carefully read the SVSU Athletics Medical Policies and Procedures.  This will explain the procedures that will take place if/when you become injured/ill including medical referrals, insurance coverage, medical bills etc.
  • Personal Information Consent Form (HIPPA Form):  Please carefully read the written statements regarding release of personal information by SVSU faculty/staff.  Please fill out the information at the bottom of the form and return with the rest of your medical records.
  • Nutritional Supplement Information Form:  Please carefully read the written statements regarding the usage of nutritional supplements. Please fill out the information at the bottom of the form and return with your medical forms.
  • HMO Authorization Form:  If your primary insurance is an HMO, please fill out and mail to your insurance company.  If you do not have an HMO, please disregard this form.
  • Minor Consent Form: If you are currently under the age of 18, please fill out form with all the signatures and return with your medical paperwork.
    
    
• The following information should be completed and sent back to the address provided below:
  
  
  SVSU Athletic Training Department
  7400 Bay Rd.
  University Center, MI 48710
  
  
• All forms must be filled out completely and postmarked by JULY 1, 2009.

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