sport hdr
Student-Athlete Pre-Participation Forms

To be cleared medically by the athletic training staff, all student-athletes and parents of student-athletes (new, returning, and transfer student-athletes) must complete and return the following forms to the Athletic Training Department. All student-Athletes will have an athletic physical that will be conducted by the athletic training staff, the Cowell Wellness Center and team othopedic physicians.  This exam will be arranged by the athletic training staff.  Physicals are mandatory for all student-athletes.  

Summer Physicals
If your student-athlete will be attending summer school at the University this year, you may complete your physical on one of the following dates: June 30 or August 4.  However, the following must be completed prior to attending summer physicals:  They must be enrolled as a student for the summer sessions, complete physical paperwork (including all laboratory work), and pay the health center fee.  Paperwork for summer physicals will be due by the following dates: For June 30 they are due by June 16 - For August 4 they are due by July 15.  Please contact Annette Martinez by phone or email if you choose to attend summer physicals or if you have any questions.

Fall Physicals
All teams will have an assigned date for fall physicals if you are unable to attend summer physicals.  You may contact your coach or Annette Martinez for these dates.  Physical paperwork for fall physicals is due by July 17.  Please send necessary paperwork for fall physicals to the following address.

Pacific Athletic Training
Attn: Annette Martinez
University of the Pacific
3601 Pacific Ave.
Stockton, CA 95211

For your insurance information we are posting our policy which indicated payment responsibilities for injuries/conditions your student-athlete may experience.  Please retain a copy for your records and reference.  If you have any questions or are unable to access or download these forms please contact Andrew Gepford at (209) 946-2588 or agepford@pacific.edu

Patient Responsibility Form

 

***Each student-athlete should download all the forms in the section that applies to them.
Download according to new & transfer student-athlete section or returning student-athlete section.

All Forms in PDF Format
Download Free Acrobat Reader

 

New & Transfer Student-Athletes
Insurance Letter
Insurance Information Form
Health Requirements for New Athletes
Authorization for Release of medical Information
New Athlete Check-Off Sheet

Returning Student-Athletes
Insurance Letter
Insurance Information Form
Returning Athlete Check-Off Sheet
- TB test required (each year)

If you have any questions or are unable to access or download these forms please contact Annette Martinez at
(209) 946-2588 or amartinez@pacific.edu
***All Athletes: Please send a copy of your insurance card (front and back) with the forms.