Get Ncaa Medical Exception Documentation Reporting Form

The Ncaa Medical Exception Documentation Reporting Form is essential for documenting the medical need for a student-athlete to receive treatment for Attention Deficit Hyperactivity Disorder (ADHD) with banned stimulant medication. This guide provides a comprehensive overview of the form and step-by-step instructions for filling it out accurately online.

Follow the steps to complete the Ncaa Medical Exception Documentation Reporting Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the institution name. Ensure that the name of the university, such as DePauw University, is correctly filled in the designated field.
3. Provide the information for the institutional representative submitting the form, including name, title, email, and phone number. Double-check all entries for accuracy.
4. Fill out the student-athlete's personal information, including their full name and date of birth. This step is critical for identifying the athlete correctly.
5. Proceed to the section for the student-athlete’s physician. The treating physician must print their name, state their specialty, and provide their office address.
6. The physician should sign and date the form, confirming their authenticity and the details provided.
7. Include the necessary physician documentation such as diagnosis, medication(s) and dosage, and current blood pressure and pulse readings. Add comments as needed.
8. Verify that alternative non-banned medications have been considered by including relevant comments in the documentation.
9. List follow-up orders and the date of clinical evaluation clearly to ensure they are easily identifiable.
10. Attach the written report summary of the comprehensive clinical evaluation. Make sure this evaluation incorporates individual and family history, assessment of mood disorders, substance abuse, previous ADHD treatment, and is aligned with DSM criteria.
11. Submit completed ADHD Rating Scale scores as supporting documentation, ensuring accuracy and completeness.
12. Lastly, after reviewing all entries for completeness and accuracy, save your changes, then download, print, or share the form as needed.

Complete the Ncaa Medical Exception Documentation Reporting Form online to ensure your student-athlete's needs are met.