Athletic Medical Forms
Welcome to Nyack College Athletics! I am writing to ask each parent/guardian and athlete to carefully read through the enclosed letter and forms. We want to make you aware of the Sports Medicine Services that are provided by Nyack College and have you complete the necessary forms needed for participation. PLEASE REFER TO THE MEDICAL CHECKLIST FORM TO MAKE SURE YOU COMPLETE BOTH SIDES OF ALL FORMS THAT NEED TO BE RETURNED IF YOUR SON/DAUGHTER IS INTENDING TO PARTICIPATE IN ANY NYACK COLLEGE INTERCOLLEGIATE SPORTS. Completion of these forms is a MUST for participation and it assures us that you are aware of, and accept the risks of athletic participation. It also provides us with needed information when medical care must be sought.
Nyack College employs a Certified Athletic Trainer who is responsible for organizing and administering athletic training and sports medicine related services for all athletes.
The Athletic Trainer works under the direction of licensed medical physicians including our team physician- Dr. Thomas S. Bottiglieri of Professional Sports Medicine Assoc. The Athletic Trainer is responsible for the assessment of, the management and supervision of all injury and illness prevention techniques. Providing counseling and guidance for athlete’s medical injuries.
The Athletic Trainer will determine when and where athletes will be referred for medical care, diagnosis, and specialize medical services. Athletes will be referred to the Team Physician and must receive clearance by the Team Physician when re-entrance into athletics is sought when an injury is referred. Evan if an accepted substitute has been arranged in advance with our medical staff (especially reference to HMO’s), athletes must also receive clearance by the Team Physician in order to return to athletics. Athletes are free to seek “second medical opinions” at their own expense and risk.
Since the coaches at Nyack College are not involved with medical care and injury assessment, we encourage parents and athletes to communicate directly with the Athletic Trainer when there are questions and concerns. The address and the phone number are listed below.
Please fill out all enclosed forms and make sure an ATHLETIC PARTICIPATION MEDICAL EXAM is obtained prior to the beginning of school.
ATHLETE INFORMATION FORM
ATHLETE INSURANCE POLICY
ATHLETIC MEDICAL POLICY
ATHLETIC PARTICIPATION MEDICAL EXAM
CHECKLIST FOR ATHLETIC PARTICIPATION
DECLARATION OF MEDICATION FORM
HIPAA ATHLETIC FORM
PARENTAL INSURANCE INFORMATION FORM
PARENTAL MEDICAL RELEASE FORM
SICKLE CELL TESTING DOCUMENTATION
NOT BE SENT TO ADMISSIONS OR THE SCHOOL NURSE!!
SEND ALL FORMS TO THE ADDRESS BELOW
Penny W. Foland, ATC
Head Athletic Trainer
1 South Blvd.
Nyack, NY 10960
Fax: (845) 353-2147