This is a multi-purpose form that informs the student-athlete of the inherent risk associated with participating in any athletic activities within the intercollegiate athletic department at an NCAA member institution. The subsequent sections allow the sports medicine staff to evaluate and treat any injury that might occur during an intercollegiate activity as well as allowing the sports medicine department to disclose information about those injuries to the individuals listed on the form and only those people. This form also includes an NCAA HIPAA form that allows the NCAA member institution to keep medical file on a secure server at the NCAA Headquarters as well as allows the NCAA to perform random drug testing to any student-athlete.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.Formulario General de Medicina Deportiva de Pre-Partipación, Asunción de Riesgo, Consentimiento para Recibir Atención Médica y Liberación de HIPAA - Sports Medicine General Pre-Participation Form, Assumption of Risk, Consent to Receive Medical Care, and HIPAA Release
State:
Multi-State
Control #:
US-01717BG
Format:
Word
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