Sports Medicine Forms

Dear Parent/Athlete,

Welcome to Nyack College Athletics!  I am writing to ask each parent/guardian and athlete to carefully read through the enclosed letter and forms. We want to make you aware of the Sports Medicine Services that are provided by Nyack College and have you complete the necessary forms needed for participation.  PLEASE REFER TO THE MEDICAL CHECKLIST FORM TO MAKE SURE YOU COMPLETE BOTH SIDES OF ALL FORMS THAT NEED TO BE RETURNED IF YOUR SON/DAUGHTER IS INTENDING TO PARTICIPATE IN ANY NYACK COLLEGE INTERCOLLEGIATE SPORTS.  Completion of these forms is a MUST for participation and it assures us that you are aware of, and accept the risks of athletic participation. It also provides us with needed information when medical care must be sought.
 

Nyack College employs Certified Athletic Trainer(s) who are responsible for organizing and administering athletic training and sports medicine related services for all athletes.

 The Athletic Trainer(s) works under the direction of licensed medical physicians including our Team Physician- Dr. Thomas S. Bottiglieri of Columbia Doctors of New York Presbyterian/Columbia University Medical Center.  The Athletic Trainer is responsible for the assessment, the management, and the supervision of all injury and illness prevention techniques and providing counseling and guidance for athlete’s medical injuries.
 
The Athletic Trainer will determine when and where athletes will be referred for medical care, diagnosis, and specialized medical services. Athletes will be referred to the Team Physician and must receive clearance by the Team Physician when re-entrance into athletics is sought after an injury is referred. Even if an accepted substitute has been arranged in advance with our medical staff (especially reference to HMO’s), athletes must also receive clearance by the Team Physician in order to return to athletics. Athletes are free to seek “second medical opinions” at their own expense and risk. 
 

Since the Coaches at Nyack College are not involved with medical care and injury assessment, we encourage parents and athletes to communicate directly with the Athletic Trainer(s) when there are questions and concerns. The address and the phone number are listed below.

 Please fill out all enclosed forms and make sure an ATHLETIC PARTICIPATION MEDICAL EXAM is obtained prior to the beginning of school.  

ATHLETIC MEDICAL FORMS - Only for new Nyack College Student-Athletes, whether you are a Freshman, Transfer, & or current student, joining Athletics for the first time.

1. Checklist for Athletic Participation
2. Athlete Medical Policy
3. Athlete Insurance Policy
     --Athletic Insurance Brochure 
4. Athletic Participation Medical Exam
5. Declaration of Medication Form
6. Sickle-Cell "Trait" Policy + Testing Guideline
7. HIPAA Athletic Form
8. Parental Insurance Information Form
9. Parental Medical Release Form
10. Athlete Information Form
11. A Current Copy of your EKG (within one year)
12. EKG Pre-Registration Form
13. Female Questionnaire (females only)
14. Mental Health Policy Form

 

TRY-OUT FORMS - Forms needed for visiting recruits who plan on doing their one time practice/try-out any intercollegiate sports team at Nyack College.

1. Try-out Medical Form
2. Try-out Sickle-Cell "Trait" Waiver Form
3. Try-out Waiver Form



FORMS SHOULD NOT BE SENT TO ADMISSIONS OR THE SCHOOL NURSE!!
SEND ALL FORMS TO THE ADDRESS BELOW

Penny W. Foland, ATC
Head Athletic Trainer
1 South Blvd.
Nyack, NY 10960
(845) 675-4780
Fax: (845) 675-4771
Penny.Foland@nyack.edu