East Stroudsburg University Athletic Training Medical Forms Information and Directions

Transcription

1 East Stroudsburg University Athletic Training Medical Forms Information and Directions All student athletes must complete all medical information forms on the ATS Webportal by July 27 th, Secondly, all student athletes must either complete a Sickle Cell Solubility Test or decline sickle cell testing by signing a waiver (please refer to the student athlete sickle cell trait directions for more instructions). Lastly, all new athletes must complete an Athletic Participation Physical. The athletic physical form listed is the only physical form that will directly qualify you to participate in ESU intercollegiate athletics. The physical must be conducted within 6 months of your first official university practice and the physical must be conducted by a physician. The physical is only required for all new student athletes. Directions to access the medical forms are detailed below. LATE FORMS COULD RESULT IN DELAYED CLEARANCE for ATHLETIC PARTICIPATION. No student athlete is permitted to participate in athletics at ESU without being cleared by the Athletic Department. Please follow the directions below to complete all necessary paperwork All medical information forms are to ONLY be submitted electronically on the ATS Webportal; printed copies will not be accepted. Directions to access and complete medical forms: 1. Start your internet browser (Internet Explorer does not allow for all access to forms. Alternatives include, Google Chrome, Mozilla and Firefox) to access the web page: (note there is not www) If you are having issues you can connect to the athlete portal via the (ESU Athletics website). A direct link will be found under the calendar on the right hand side. 2. Enter your athlete ID Enter NEW as your athlete ID 5. Enter NEW as the password 6. If the database is blank: enter atsesu 7. The Athlete Information Screen should appear. 8. All Highlighted spaces must be completed. Other spaces are helpful, but not required. a. Athlete ID is your six digit student ID number b. Athlete Password is your choice c. Finally click Save Athlete Information 9. Return to the top of the screen, five other tabs should appear. 10. Next click to the Medical History tab a. If you have had a previous surgery, please select green add tab under Surgeries and complete the information requested b. Continue to the Medical Questions; All questions must be answered yes or no for yourself, or the family box if an immediate family member has the ailment. If

2 you answer yes to one of the questions, please indicate the condition and year in the Other Information box c. Save Medical History; A text box stating Save Complete should appear. 11. Next click to the Insurance tab a. Click the green add tab b. If the name of your insurance company is not under the company you can add the name under the Add a New Insurance c. Payer # is 1for your primary insurance; 2 for secondary if necessary d. The uploaded front and back image of your insurance card is required. e. Click the small check mark at the bottom of this page to save. 12. Next click to the Contacts tab a. Click the green add tab b. Contact # refers to the order in which you would like us to call. 13. Next click on the Athlete Forms tab; there are four medical forms required for all student athletes. a. Select the form from the drop down form name menu b. Click on the new button to the right of the form name i Athletic Medical Procedures: Read information, type your name in Student Athlete Name, Parent/Guardian signature is only required if you are under 18 years of age. *The Signature box requires on electronic signature. Use the mouse to sign your name in the box and type your name as you would sign it in the Signed By: box. (If you are a minor, a parent/guardian will have to sign on your behalf. Please have your parent/guardian sign their name in the box and type their name in the Signed By: box.) Then click Sign. Once this is complete click Save Complete the form and click the save button at the bottom of the page. You will receive a pop up on the screen reporting the form was saved. You only need to click save ONCE every time you click save a new form will be created! Finally, return to the top of the screen, scroll to the next form and select new to access. ii Assumption of Risk: Read, type your name in Student Athlete Name, Parent/Guardian signature is only required if you are under 18 years of age. Follow the directions above to complete the signature. iii Treatment Consent Form: Read, type your name in Student Athlete Name, Parent/Guardian signature is only required if you are under 18 years of age. Follow the directions above to complete the signature. iv. ESU Sickle Cell: Read; Under Choice of Test please select the appropriate option. Note: if you select test at birth or recent test you must provide the information in the Testing Information and Test Result section. The directions on how to complete Sickle Cell Testing are located under the e files tab. If you choose the Sickle Cell Waiver option you may skip the above section and click yes under the Sickle Cell Waiver below. If you do select the Waiver option you must also complete the Sickle Cell Testing Waiver under the e files. Next Type

3 your name in the Student Athlete Name, enter the date and sign. Follow the directions above to complete the signature. 14. Next click the e Files tab a. Sickle Cell Testing. i. If you have chosen to undergo Sickle Cell Testing, download the Sickle Cell Testing Directions. They will explain the procedure. ii. If you have chosen the Sickle Cell Waiver option, you will need to electronically upload the Sickle Cell Waiver. Click on the green arrow in the view column and follow the directions to download the file. Next, type your name in under the Sickle Cell Trait Testing Waiver and continue to the electronic signature section. Click on the red arrow in the student athlete signature section. You will be prompted to complete an electronic signature. If you have not created a digital ID before follow the directions below: 1. Select New ID from the drop down list 2. Click the circle next to A new Digital ID I want to create now 3. Click next 4. Enter your name, Organizational Unit is the name of your sport, organization Name is ESU, Enter a valid address, then click Next 5. Enter a password, then confirm. 6. You will then be asked to enter the password to apply the signature. 7. Once the signature is applied, you will be prompted to save the document. Be sure to save it in a place that is easily accessible. Finally, upload the document by clicking on Choose File, attach the appropriate document and enter the name Sickle Cell into the description section. Hit upload and the process is complete. b Athletic Physical: All first year (freshman, transfers, and first time walk ons) i. Electronically upload the Physical form ii. Take this document to your physician to have completed prior to the deadline of July 5 th. Please be sure to complete all information. iii. Mail the completed form to the address listed on the top of page 1 of the Physical Form. c. Other important e Files: Download as appropriate i. Medication Any student athlete that is currently taking prescription medications for Attention Deficit Disorder, Anxiety, or Depression must have a letter from the prescribing physician ON FILE within the Athletic Training Room. The medications normally prescribed for the above conditions can result in a positive NCAA drug test. The information is required by the NCAA to be On File prior to any drug testing administration as athletic eligibility can be affected by a positive drug test.

4 ii. The NCAA Drug Testing Document, the ESU HIPPA document, and the ESU S A Concussion form will be completed when you arrive on campus. Your team will have a designated time in which you will meet with an athletic trainer to watch informational videos in addition to signing the aforementioned forms. *In order to be cleared for participation in ESU athletics, all student athletes must complete all forms by the deadline on the ATS Webportal, and all first year participants must receive a sports physical from their primary care physician using the Report of Medical History Form. If you experience any problems or have any questions please contact the Athletic Trainer responsible for the sport you participate in. The athletic trainers will be in the office until May 31 st Should you need attention from June 1 st through July 28 th, please contact your sports coach. Sport Men s Basketball Women s Basketball Men s Soccer Women s Soccer Softball Cross Country Cheerleading Field Hockey Volleyball Wrestling Lacrosse Baseball Men s Track Football Swimming Tennis Golf Women s Track Athletic Trainer/Athletic Director Colleen Shotwell Coordinator of Athletic Training John Paolini Athletic Trainer Wendy Dietrich Athletic Trainer Dr. Tom Gioglio Athletic Director Contact Information cshotwell@po-box.esu.edu phone: fax: jpaolini@po-box.esu.edu Phone: Fax: wwheeler@po-box.esu.edu Phone: Fax: tgioglio@po-box.esu.edu Phone:

5