Physical Forms

The following information will need to be filled out completely and returned to the Athletic Training Department by July 25, 2014. If you are having difficulty obtaining the forms please feel free to e-mail or call Jon Mitchell, MA ATC at (704) 406-3912 or jmitchell@gardner-webb.edu.

 


 

All First-Year Participants in Athletics at Gardner-Webb University
Includes Freshmen and Transfer Students
 
Complete First-Year Participant Packet
Vice President for Athletics Insurance Letter
Gardner-Webb University Insurance Requirements
Acknowledgement of Insurance Statement
First Agency HIPPA
Parent Information Form
Hospital Emergency Information Form
Medical History Form
Female Pregnancy Statement
Substance Abuse Education and Testing Policy
Substance Abuse Education and Testing Policy - Appendix A
Consent to Participate/Medical Consent Form
Helmet Warning
NCAA Concussion Statement
Student-Athlete Concussion Statement
Concussion Screening Recovery Scale
HIPPA
Nutritional Supplements Disclosure
Prescription Medication Disclosure
Sickle Cell Trait Student-Athlete Letter
Copy of Documentation of Sickle Cell Trait Status
 
Note: All forms must be completed in FULL.  Please send completed forms and a copy of the front and back of your insurance card along with your sickle cell trait status to the following address:

Gardner-Webb University
Athletic Training
PO Box 877
Boiling Springs, NC 28017


Second, Third, Fourth, and Fifth Year Participants in Athletics at Gardner-Webb University
Includes Sophomores, Juniors, Seniors, and Fifth-Year Seniors
 
Complete Second, Third, Fourth and Fifth Year Participant Packet
Vice President for Athletics Insurance Letter
Gardner-Webb University Insurance Requirements
Acknowledgement of Insurance Statement
First Agency HIPPA
Parent Information Form
Hospital Emergency Information
Medical History Update Form
Substance Abuse Education and Testing Policy
Substance Abuse Education and Testing Policy - Appendix A
NCAA Concussion Statement
Student-Athlete Concussion Statement
HIPPA
Nutritional Supplements Disclosure
Prescription Medication Disclosure
 

Note: All forms must be completed in FULL.  Please send completed forms and a copy of the front and back of your insurance card along with your sickle cell trait status to the following address:

Gardner-Webb University
Athletic Training
PO Box 877
Boiling Springs, NC 28017

 

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