There are four pages to the Medical History. Please download the form, complete all sections, sign, and then scan and return the scanned PDF to Angela D’Amelio at email@example.com.
Download the Sports Physical form and take it to your doctor or medical provider. They need to complete the form, and then scan it and return the scanned PDF to Angela D’Amelio at firstname.lastname@example.org.
NWAC Regulations state: “After July 1st and prior to the first practice for participation in intercollegiate athletics, a student shall undergo a thorough medical examination and be approved for intercollegiate athletic competition by a medical authority licensed to perform a physical examination by the laws applicable in the state where the exam is conducted. Those licensed and approved to perform physical examination by the laws applicable in the state where the exam is conducted.”
Those licensed to perform physical examinations in the State of Washington include M.D., Doctor of Osteopathy (D.O.), Certified Registered Nurse (C.R.N.), Naturopath (N.D.) and Physician’s Assistant (P.A.). The physical examination shall be valid for twenty-four (24) consecutive months to the date unless otherwise limited by the physician indicating the physical is only good for less than twenty-four (24) consecutive months.
This form is to be completed and signed by the student or, if the student is under the age of 18, by the student’s parent or guardian. Any information withheld or falsified may affect the student’s status on the athletic team and/or the student’s scholarship funding. The college reserves the right, with the student’s authorization, to request past medical records, charts and diagnoses regarding injuries, medical history or physical condition, and may request additional medical examinations or tests if indicated.
Last Updated July 11, 2022