Pre-Participation Medical Requirements

☐ Health Form

Preparticipation Physical, completed by your Primary Care Physician and submitted to WNE Health & Wellness in person at CSP 235 or via email at Healthservices@wne.edu

HEALTHY ROSTER ATHLETIC TRAINING REQUIREMENTS

Creating your profile

Uploading insurance cards

☐ New Student Athletes: Create Profile

You will receive an email with instructions and a link to create your account and download the app. 

☐ Demographics

Name, Home Address, Graduation Year, Cell phone number, Unique ID (your 6-digit WNE student ID number)

☐ Emergency Contacts

*Must be done from a computer, not phone* 2 contacts with name, relation & cell phone 

☐ Insurance Card

Upload pictures of the front and back of your insurance card via App

☐ Medical Consent and Disclosure form

Print out form from a computer. Sign form, (patent’s signature also required if you are under 18.) Upload a picture of the signed Disclosure form via App.

TESTING & EDUCATION

☐ ImPACT

All student-athletes need to complete a baseline ImPACT test upon return with a member of the WNE AT staff prior to participation. 

☐ SCAT5

All student-athletes need to complete a baseline SCAT5 test upon return with a member of the WNE AT staff prior to participation. 

☐ Concussion Education

All student-athletes must complete concussion education annually at the time of their baseline ImPACT test.

ADDITIONAL FORMS

☐ ADD/ADHD Medication Waiver

Student-athletes taking medication for ADD or ADHD must submit a form filled out by the PRESCRIBING MD. If medication or dosing changes, you must submit a new form.

ADD Form page 1   ADD Form 2