Walk-On Student-Athletes - Iowa State University Athletic Training
Walk-On Student-Athletes

In order to participate in any officially sanctioned team practices, events, or conditioning sessions, prospective walk-on student-athletes must present required paperwork that is listed below.  Clearance for athletic participation will be prohibited until all paperwork is turned in and approved by the ISU Athletic Training Staff and Team Physician.  Required paperwork and forms are listed below numerically.  Simply print off and complete all paperwork, and return to the contact person listed at the bottom of the page.

All new walk-on student-athletes will be responsible for obtaining their own athletic physical and any costs incurred.  Athletic physicals must have been completed within the past six months to by a licensed physician.   This physical examination must include standard blood lab work, urinalysis, and sickle cell testing (you may need to request this from your physician).

Athletic Health History and Pre-Participation Physical Examinations

1. Initial Student-Athlete Health Evaluation Form
2. Pre-Participation Physical Form (to be completed by a licensed MD, DO, or Phys. Asst. -- must include all lab work)
3. Student-Athlete Supplement/Ergogenic Aid Notification Form

Medical Insurance
All walk-on student-athletes must provide the athletic training staff with proof of insurance coverage in order to participate in practice.  Student-athletes that do not have health insurance must also complete these forms.  These students will be required to purchase individual insurance coverage through Iowa State University Student Health Insurance or another carrier.  Any question regarding insurance issues should be addressed to the Athletic Insurance Coordinator, Erin Wilson at 294-2946. 

4. Student-Athlete Insurance Form

5. Insurance Information Verification Form

 

Medical Records, Policies, and Medical Release Forms

As a component of Iowa State University, it has been determined that the Iowa State University Athletic Health Care department is a covered entity and falls under the federal rules and regulations mandated by the Health Insurance Portability and Accountability Act of 2003.  Compliance and rules regarding HIPAA qualified information at the university have been established in a university-wide policy.  Further information regarding privacy practices of medical records at Iowa State University may be found in Notice of Privacy Practices for Iowa State University Health Care Providers.

 

 

6. Acknowledgment for Receipt of Notice of Privacy Practices Form

7. Release and Indemnification Form

8. Release and Indemnification Form for a minor (needed only if under age 18)

9. Authorization for Release of Medical Information Form

10. Verification of Medical Policies and Procedures Form

11. Consent for Treatment of a Minor Form (needed only if under age 18)

 

All forms once completed should be returned via FAX, digitally scanned, hand delivered, or traditionally mailed to the following address as soon as possible.  Forms must be received at least 1 week prior to the anticipated athletic participation starting date.

 

Erin Wilson

Iowa State Athletics

Jacobson Athletic Building

1800 South Fourth Street

Ames, Iowa 50011

 

ewilson@iastate.edu

 

FAX (515) 294-6554

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