Varsity Athletic Forms
TO: Parents/Guardians of Colorado College VARSITY ATHLETES
FROM: Ken Ralph, Director of Athletics
We are very excited that your daughter or son has chosen Colorado College to continue their athletic career and receive a great education. We want to take this opportunity to make you aware of a few points in regards to the medical care and coverage that your student will receive while they participate in athletics.
All incoming freshmen student-athletes must have an entrance physical which is required as part of the admission process. That physical is not used for athletic purposes. Each athlete must annually complete a sport physical with the CC Sports Medicine Staff. The Medical History Questionnaire (Form 1) must be completed by each athlete and will be used at our on-site sports physicals scheduled prior to sports start dates. This form should not be signed by your personal physician.
As a condition of enrollment at ColoradoCollege, all students must present proof of health insurance. Additionally, as a condition for participating in intercollegiate sports, the Athletic Department requires proof of adequate health insurance which provides coverage for injuries occurring as a result of participation in intercollegiate practice and competition. This insurance requirement is a pre-requisite for practice and competition. Please refer to form 2 for definitions of adequate insurance.
If you have questions regarding the terms of your coverage, you should contact your insurer immediately. Please be sure to note if there are exclusions in your policy relating varsity athletic injuries.
If you change insurance after the beginning of the sports/academic year, please notify the Athletic Insurance Coordinator. Failure to do so will make you responsible for payment of medical bills incurred.
Per the NCAA’s 2010 implementation of protocol regarding Sickle Cell testing which states that “all Division 1 student-athletes must (a) be tested for sickle cell trait, (b) show proof of a prior test or (c) sign a waiver releasing an institution from liability if they decline to be tested”, please see following forms and waiver.
Please make sure to return the following forms (and copy of insurance card) by July 2nd if you are a Fall Start, and January 2nd if you are a Winter Start.
Note that these forms need to be printed and sent back via fax or print mail (though you can fill out many of the fields on your computer before printing).
- Form 1: Medical History Questionnaire (completed by athlete)
- An on-site sports physical will be held by the sports medicine staff after your arrival to campus. Your coach will notify you of date and time of this sports physical as well as a mandatory sport organizational meeting. Attendance for both the meeting and physical is mandatory for sports participation. Form 1 will be used by your athletic trainer and team physicians to determine medical clearance for sports participation. This form is for internal use only and should not be signed by your personal physician.
- Form 2: Varsity Athletics Participation Requirement Sheet (parent & athlete signature)
- This form is informational only and requires acknowledgement of receipt of information regarding secondary insurance for varsity sport injuries. Please review carefully.
- Form 3: Insurance Information Sheet
- Personal and primary insurance information which will be verified, documented and used by our sports medicine staff in the event medical care is needed.
- Form 4: HIPAA/Authorization for disclosure release form (completed by athlete)
- Signed document required for HIPAA privacy compliance.
- COPY OF MEDICAL INSURANCE CARD (FRONT & BACK)
- Div. 1 athletes only - Sickle Cell testing document & result or waiver
Questions and forms return should be directed to:
Celina Swedlund, Athletic Insurance Coordinator
El Pomar Athletic Center, Colorado College
14 E. Cache La Poudre Street
Colorado Springs, CO 80903
719-389-6321 (phone)/719-389-6993 (fax)
We hope you find this information useful. Thank you for your help to provide optimum health care for our students.
Colorado College Athletic Director