Athletic Training

PHYSICAL / INSURANCE FORMS

Dear Student-Athletes and Parents/Guardians,

We would like to welcome you to Montclair State University and our fine Athletic program.  The Athletic Training/Sports Medicine (AT/SM) staff is charged with helping to provide a safe and healthy experience while at MSU.  All student-athletes are required to complete and hand in appropriate paperwork on an annual basis.  Please use this letter as your personal medical checklist and the links below to point you to the correct forms.  Only download and complete the appropriate forms.  We suggest, when possible, filling out the forms on line using the MS Word format and then printing the form.  This will help you eliminate handwriting mistakes and us trying to decipher your handwriting.  The forms are also available in PDF format if you prefer to print the form and then complete it by hand. FYI - we organize our files by years of participation at MSU, not academic status or eligibility.

If you have questions, don’t hesitate to call (973-655-5250) or e-mail the AT/SM staff.  

Everyone should read the forms below.

• Pre-Participation Paperwork Letter
• 2011 Physical Schedule
• Preparing for Pre-Season Camp  
• Insurance Explanation

• NCAA Guidelines to Document ADHD Treatment with Banned Stimulant Medications
  (*Only if athlete is taking medication for these conditions)
  
  
• Immunization Requirements for Housing

Everyone should complete and return the forms below annually.

• Parent Insurance Information Form  - Word / PDF
  Please, also include copies of family insurance forms (front & back)
  
  
• Disclosure/Consent Form - Word / PDF
  
  

Complete the appropriate forms below.

• Underage Medical Consent Form – Word
  *If athlete will be underage at the time of the preseason physical at MSU.

• ADD/ADHD Exemption Form – Word
  *If athlete is taking medication (i.e. - Ritalin, Adderall) for these conditions.
  
  
• Sickle Cell Trait Information - Word
  * All new incoming athletes, both freshman and transfers MUST READ, COMPLETE AND
  SUBMIT THIS FORM PRIOR TO PARTICIPATION
  

Complete Medical History form or Yearly Update.

• First Year Playing @ MSU (long medical history form) - Word / PDF
• Second Year Playing @ MSU (update form) - Word / PDF
• Third Year Playing @ MSU (short form, but full physical) - Word / PDF
• Fourth Year Playing @ MSU(update form) - Word / PDF
• Fifth Year @ MSU(short form, but full physical) - Word / PDF

Immunization Form – This is collected as a part of your general admission material, and should be on file in the MSU Health Center.  We do not need copies of these forms.  Meningitis immunization is recommended for all students and is required for any student living on campus – even if just for preseason.  For further information, check the Health Center website, www.montclair.edu/health/hc

Do not mail or return the forms to the coaches.  Please give or mail them to the Athletic Training Staff.

John Davis
John Davis / Dr. M. Benjamin Burton
Athletic Training and Sports Medicine Center
Panzer Athletic Center
Montclair State University
Montclair, NJ  07043
davisj@mail.montclair.edu