Dear Parent/Guardian and Student/Athlete:
NCAA MANDATED SICKLE CELL TESTING/WAIVER FORM -- FRESHMAN/TRANSFERS ONLY MUST COMPLETE WITH SPORTS MEDICINE PACKET
Your son/daughter has shown interest in competing in athletics here at Washington & Jefferson College. We are kindly requesting that you please complete the following information that you will find on the links on this website. It is required for your son/daughter to have these papers returned to the athletic training offices BEFORE they are permitted to practice. This information will assist us with completing a medical file for your son/daughter.
Any injuries incurred while participating in intercollegiate sports practices or games MUST be reported IMMEDIATELY to the athletic trainers so that proper treatment may be administered and any insurance claims may be completed if necessary. All injuries affecting game and practice preparation must be checked and cleared by the Washington & Jefferson College's team physicians, regardless of insurance (NCAA Sports Medicine Guideline 1B). If a referral is required in order to be seen by a physician, it is important that we try to have the treatments administered by your insurance company's participating providers when possible.
Please be reminded that all students are required to have health insurance coverage during the entire school year, either through a family or individual policy, or through a policy made available to students which may be purchased through the College. It is important to note that the health coverage purchased through the College does NOT cover injuries which occur during participation in intercollegiate sports.
The insurance purchased through a family or individual policy or purchased through the College is the PRIMARY INSURANCE. All claims will be billed to this insurance. Therefore, it is imperative that you FOLLOW YOUR PRIMARY INSURANCE CARRIER'S MANAGED CARE GUIDELINES relative to participating providers, covered charges, number of allowable visits, referral procedures, network physicians, etc. Your primary health care plan coverage designs may vary and often incorporate deductibles, co-pays, etc., which will be YOUR responsibility.
In addition, the College purchases SECONDARY COVERAGE for the students participating in intercollegiate athletics. This coverage provides a secondary level of medical coverage. However, this secondary insurance, like all health insurance policies, has limitations of coverage. Any costs not paid by the combination of primary and secondary insurance (including the $500 deductible) would be your responsibility. Should your primary insurance not cover the injury for some reason, please be aware that the secondary insurance provided by the College carries a $500 deductible, which YOU will be responsible to pay. Should you need to use the secondary coverage, please check with the provider of the secondary coverage PRIOR to obtaining any medical procedures, tests or doctor visits to ascertain coverage.
The College CANNOT guarantee, however, that all medical bills relative to a sports injury will be paid in full.
Fall sports practices begin during mid-August, so coverage is needed for the full month of August. If you need more information or have any questions, please contact the W&J Business Office.
If a student/athlete gets injured while participating in athletics and was seen by a physician and it was necessary to bill their personal insurance, the parents/guardians will be notified via a letter mailed to the student's home address. The letter will contain a copy of the claim form that was completed by your son/daughter and signed by the athletic trainers and another letter once again explaining the College's insurance with phone numbers of a contact person for that company to whom you may direct any questions about the injured athlete's claim. Any questions about insurance claims and paperwork should be directed to the College's insurance company and NOT the athletic training department.
Athletes may NOT participate in any aspect of sports practices or games without having completed the following: proof of health insurance coverage, a completed Medical History Questionnaire, a completed Insurance Information Sheet, sickle cell test result/waiver form, copy of front and back of insurance card, and a pre-participation physical examination completed by the College's team physicians. All paperwork must be completed and returned no later than AUGUST 1 to the athletic trainers. The NCAA does not accept the physical examination that is required for entrance into the college. Please complete all information on the forms (links on left of this page).
Please complete and sign all appropriate paperwork and send it before August 1 to the following address:
Athletic Trainers
Washington & Jefferson College
60 South Lincoln Street
Washington, PA 15301
Any athlete with a known pre-existing medical condition (i.e. heart murmur, kidney disorder, diabetes, chronic illness) must present a letter of clearance to participate in his/her specific collegiate sport(s) from a specializing physician. Please bring this letter to the pre-participation physical and give it to the examining physician. This letter will remain in the athletes file and is valid for only one year. A new letter must be obtained every year. If the examining team physician discovers a medical condition during the screening, the athlete will still not be permitted to participate in any of the teams activities until cleared by a specializing physician as per the team physician's instructions.
Please follow all of the instructions above and on the enclosed forms so we can create a file for your medical records here in the Washington & Jefferson College Athletic Training Department. Again all paperwork MUST be received prior to your son or daughter being able to participate in athletics at Washington & Jefferson College. If you have any questions regarding these papers please feel free to contact Mike Lesako or Mark Lesako, the athletic trainers at 724-223-6062. Once again, any questions concerning the college's insurance policy should be directed to the Washington & Jefferson College Business Office. Thank you for your time and assistance with the completion of this very important paperwork.
Sincerely,
Mike Lesako, Athletic Trainer
Mark Lesako, Athletic Trainer
