Pre Participation Information

Dear Eckerd Student-Athlete/ Parent/ Guardian:

We are pleased to welcome you to Eckerd College for the upcoming academic year and athletic season. This site is designed to give you pertinent information pertaining to your participation as an Eckerd student-athlete during the 2007-2008 school year. The Eckerd College Athletic Department is concerned for the physical well-being of all of our student-athletes. The purpose of this memo is to explain the procedures regarding pre-participation physicals and athletic insurance coverage for injuries sustained while participating in our intercollegiate sports program.

Although a diligent effort is made by the Athletic Department to minimize risk of athletic injuries, there is always the possibility of injury through participation in sports activity. You will find links to all of our required forms listed below. The forms must be completed in order for the athlete to qualify for participation in our intercollegiate sports and secondary insurance coverage for athletic injuries. If you have any questions regarding these forms please contact us at 727-864-8255/7831.

Please review all the forms. Each of the forms contains information important to the student-athlete. Incomplete forms will not be accepted.Student-athletes will not be allowed to practice or compete until all the information is provided. Please find the following forms need to be completed by July 15, 2007 and returned to the Sports Medicine Department.

1. Medical History Questionnaire.pdf (signature required)
2. HIPPA consent form.pdf (signature required)
3. Insurance Information form.pdf (signatures required)
4. A copy of primary insurance card (front and back of card)
5. Signed Eckerd Athletic Department Insurance Consent Form.pdf (signatures required)

After we have received all of the above items (please note upon review of the medical history form we may request additional information), the student-athlete must complete the following:

1. Pass an extensive physical examination given by Eckerd College Team Physicians.
2. Pass any additional test recommended by the Medical Staff, which will be the responsibility of the student-athlete and his/her primary insurance.
3. After completion of this pre-participation exam, review by the Medicine Staff and consultation with the Athletic Director, a decision will be made concerning the playing status of the student-athlete.

There should be 6 pages (including copy of front and back of insurance card) being returned to the Athletic Training Department. Mail or fax completed forms to:

Eckerd College Sports Medicine
4200 54th Ave South
St Petersburg, FL 33711
Fax- 727-864-8968