2011-12 Athletic Forms
Grinnell College requires ALL student-athletes to undergo a medical examination (physical) administered or supervised by a physician. The examination must be administered within six months prior to participation in any competition or practice (including non-traditional season practice).If you are an incoming First-Year student, you have been sent a Student Health Record in your Admission Packet (the Student Health Record is a 6-page form on white cardstock). Completion of the Student Health Record satisfies your athletic medical examination requirement AS LONG AS THE EXAMINATION IS WITHIN SIX MONTHS OF YOUR FIRST TEAM PRACTICE.All forms should be completed and returned to the PEC Office at least 30 days prior to your first team practice. Return all forms to:
Nancy Baumgartner
Intercollegiate Athletics
1201 10th Avenue
Grinnell, IA 50112
PHYSICAL EXAM
Physical Exam 2011-12 for players
*Required for returning varsity athletes
*Administered or supervised by a physician
MEDICAL HISTORY QUESTIONNARIE (2 pages)
Medical History Questionnaire 2011-12
*Required for all student-athletes
*Completed by student-athlete
ATHLETE INSURANCE FORM
Athlete Insurance Form for parent or guardian 2011-12
*Required for all student-athletes (you must have medical insurance coverage to participate in varsity athletics)
*Completed by the policy holder
HIPPA FORM
HIPAA 2011-12
*Required for all student-athletes
*Completed by student-athlete
Questions? Contact Nancy Baumgartner at baumgart@grinnell.edu or at (641) 269-3800
