Microsoft Word - Athletic_Forms_Cover_Letter_2014.docx



Dear Parents,The athletic staff is pleased to have your son/daughter as a student-athlete at the University of Wisconsin- Platteville. We are hopeful that the opportunity presented here at UW-Platteville will be a rewarding experience and that he/she will achieve academic, social, and athletic success.Please review the following instructions to complete the forms required for athletic participation. Each form must be completed and submitted to the athletic office or athletic training room prior to your son/daughter’s participation in any practice or competition. All forms must be returned by Aug. 1. Student-athletes who submit any forms after Aug. 1 will be charged a $30 late fee. Late fees must be paid prior to any participation in athletic activities. Please submit the following forms: Physical Examination FormPhysicals must be dated after May 1 of the current year to be eligible.Each student-athlete is required to provide a medical history, current physical examination, and medical clearance prior to intercollegiate athletics participation. The physical exam must be completed and signed by a licensed physician. Physicals signed by chiropractors will not be accepted. Physicians may authorize nurse practitioners or physician assistants to stamp this form with the physician’s signature or name of clinic with which the physician is affiliated. Insurance Information Form?Attention? Please note that all NCAA Division III student-athletes must provide evidence of insurance that must have coverage of at least $90,000 which includes coverage for athletically related injuries. This is a pre-requisite for all athletic activities including practice and competition. No student will be allowed to participate in any activities until such evidence of current insurance is on file with the UW-Platteville department of athletics. If you have questions regarding the terms of your coverage, you should contact your insurer immediately. Please be sure to note if there are any exclusions in your policy regarding athletically related injuries. Photocopy of medical insurance card (front and back)The accompanying insurance form and insurance card (photocopy of both sides), must be on file before a student is allowed to participate.4.Sickle Cell Trait StatusAs per NCAA legislation, schools must confirm the sickle cell trait status of student-athletes before participation in intercollegiate athletics. Infants born after 1984 were tested for sickle cell trait and therefore the documentation should be available from your family pediatrician, or schedule an appointment with you family physician to have sickle cell testing (blood test) done. Sickle cell trait status needs to be documented only once in a student-athlete’s athletic career. 5. ______ NCAA Medical Exception For ADHD Medication FormADHD medications are banned by the NCAA as a class of stimulants. In order for a medical exceptionto be granted for use of these stimulant medications, the student-athlete must document that s/he hasundergone standard assessment to identify ADHD. The student-athlete should either provide documentationof an earlier assessment, or undergo an assessment prior to using stimulant medications for ADHD. If the student-athlete has not undergone a standard assessment to diagnose ADHD, theyhave not met the requirements for the NCAA medical exception. This form is only required if the student-athlete takes ADHD medication.Thank you for your cooperation. Any correspondence regarding these forms or athletic injuries should be addressed to: Athletic Training Room, University of Wisconsin-Platteville, 91 Williams Fieldhouse,1 University Plaza, Platteville, WI 53818-3099.Revised 2019Williams Fieldhouse | 608.342.1576 | Fax 608.342.15761 University Plaza | Platteville WI 53818-3099 | ................
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