Medical Forms

Endicott College
Athletic Training
376 Hale St
Beverly, MA 01915
Phone 978-232-2309
Fax 978-998-8013

Welcome!

On this page you will find a checklist of items that need to be completed prior to your arrival to Endicott College this upcoming year. The information that you provide in this paperwork is essential to providing the best care for our student-athletes. This paperwork is MANDATORY for all varsity and club student-athletes. Student-athletes will not be eligible to participate until all aspects of the forms are complete.

The deadlines for paperwork are as follows:

FALL ATHLETES – AUGUST 1st
WINTER/SPRING/CLUB ATHLETES – AUGUST 31st 

All paperwork submitted after the specified deadline is subject to a 48 hour processing period. During this period, athletes with tardy or incomplete paperwork will not be allowed to participate in his/her sport. If you have any further questions please contact Kevin Rooney at krooney@endicott.edu.  

DIRECTIONS

The following pieces of information can be found under the link “Student-Athlete Medical Clearance Forms” and are to be submitted ONLINE:

Please note... *YOU CANNOT COMPLETE THESE FORMS USING INTERNET EXPLORER AS A BROWSER*

  1. Student-Athlete Medical History: Please provide a brief explanation to any questions where you have answered “YES”. If you had any new injuries, illnesses, or surgeries within the last 365 days, we will require written documentation from the treating physician stating that you are cleared to participate in intercollegiate athletics.   
  2. Proof of Primary Insurance Questionnaire: please include policy # and member service phone number
  3. Assumption of Risk and Waiver: read and agree
  4. On-Campus Medical Release Waiver: read and agree
  5. NCAA Medical Exception Notification Form: all student-athletes must complete the Notification Form with the exception of equestrian and club teams.

-If you ARE NOT currently taking any medications on the NCAA banned substance list for ADD/ADHD or asthma, check the correct box and no further action is needed.
-If YOU ARE currently taking any medications on the NCAA banned substance list for ADD/ADHD or asthma, check the correct box and refer below for additional information

The following pieces of information will be submitted to the athletic training staff VIA MAIL:

  1. Current physical exam: to be conducted by your primary care physician. The form must be signed and dated within 12 months. No student-athlete will be cleared for play with an “expired” physical. If your physical expires during your season, it is your responsibility to schedule an appointment with your physician.
  2. Insurance Card Copy: include a copy of the front and back of your insurance card.
  3. Sickle Cell Trait Testing or Waiver: this is a requirement of the NCAA for all incoming 2013 freshman student-athletes participating in Endicott Athletics
  4. Medical Exception: If you arecurrently taking any medications on the NCAA banned substance list for ADD/ADHD or asthma, we require the following information from you:
  • Medical Exception Form (link located below): to be filled out by prescribing physician
  • A note from your physician describing the history of your diagnosis and care
  • Copies of evaluation procedures that assisted in your diagnosis
  • Copy of current prescription

ONLINE FORMS 

When filling out the online forms, *DO NOT USE INTERNET EXPLORER*. Use Mozilla Firefox or Google Chrome as there have been reported issues using Internet Explorer. When you have submitted the online forms successfully a “receipt” of your submission will be emailed to you.

Student-Athlete Medical Clearance Forms **DO NOT USE INTERNET EXPLORER**DO NOT USE INTERNET EXPLORER**

Returning Student-Athlete Physical Form

Freshman/Transfer Student-Athletes: Freshmen and transfer student will receive an Endicott College Health Form from the Student Development Office. Please complete the form and make two copies. Send the original to the Health Center, one copy to Athletic Training, and retain a copy for your records. It is necessary that BOTH the Athletic Training Staff and Health Services have a copy of your physical.

SICKLE CELL TESTING

Testing for sickle cell trait has recently been added to the list of NCAA requirements for athletic participation.  Typically, each newborn in the United States has already been tested for sickle cell trait, however few may be aware of their results. Please have your physician complete the Sickle Cell Testing Form below or complete the Sickle Cell Waiver form if you wish not to disclose this information or refuse testing.  Please note these forms requires your signature as well.  One of these two forms must be completed to become eligible for Endicott Athletics. If you choose to complete the Sickle Cell Waiver it  will not effect your eligibility to participate in Endicott athletics.  Please read these forms carefully.  If you should have any further questions please go to ncaa.org, keyword sickle cell or contact a Certified Athletic Trainer at Endicott College.

Sickle Cell Testing Form
Sickle Cell Waiver Form 

MEDICAL EXCEPTION FORMS AND INFORMATION

Athletic Training Forms FAQ
Medical Exceptions - ADD/ADHD Form
Medical Exception - Asthma Form
NCAA Medical Exceptions FAQ’s
NCAA Banned Drug List
NCAA Medical Exceptions – Additional Information
 Additional ADD/ADHD Guidelines 

Please mail your paperwork to the address below. We DO NOT accept faxes of any paperwork due to difficulty in reading the transmission. GO GULLS!               

Endicott College
Athletic Training
376 Hale St.
Beverly, MA 01915