Congratulations on becoming a part of one of the finest collegiate athletic programs in the country!
For any questions not answered below, please call Cal Sports Medicine Administration at 510-643-4801 or email firstname.lastname@example.org (reminder, email is not considered a secure form of communication)
For more information on the Cal Sports Medicine Program, the Sports Medicine University Health Service/Intercollegiate Athletics Joint Staff, Cal Sports Medicine Administration, please visit the Cal Sports Medicine Program page.
1. Before beginning this process, please:
2. Review the following checklist and then print the fax/packet cover sheet to include as page 1 of your completed packet.
All forms must be sent before your pre-participation physical to the following fax or address:
The fax number is (510) 643-0792.
Or mail to:
Sports Medicine Program Administration
University Health Services
2222 Bancroft Way, Berkeley, CA 94720-4300.
To ensure no delays in your clearance and participation, complete each of the following items on the checklist:
|Find the date of your Pre-Participation Physical on the schedule.|
|Complete the Athletic Health History form before your pre-participation physical by logging into the student portal (eTang), selecting FORMS and providing all information requested. If you are unable to access the Athletic Health History form, please email email@example.com|
|Print the Fax/Packet cover sheet for a list of all materials to fax/mail or hand deliver to your physical exam|
|Print a copy of the front and back of any valid health insurance card(s).|
|If you are a minor (under age 18), have your parent or guardian complete the Authorization for Third-Party Consent to Treatment of Minor form and return it to the Sports Medicine Program before your pre-participation physical.|
|Ensure that your Hepatitis B Immunization Requirement has been satisfied.|
|Read the Information and Requirements relate to Sickle Cell Trait.|
|Send copies of your medical records to University Health Services. This should include records for any orthopedic or medical condition for which you were restricted from participation during your high school career. Please also include testing and records related to ADD/ADHD or learning disabilities. Please call (510) 643-4801 to inquire about which records you should provide.|
|If you are an HMO member, select a local physician to be your primary care provider. This will ensure that your health insurance can be used in our area, and may prevent delays in getting care. If you would like a list of local Primary Care Physicians, please email firstname.lastname@example.org or call 510-643-4801.|
|Assignment of Benefits for Intercollegiate Athletic Insurance Plan form must be completed by ALL student athletes, so that we can assist in payment for athletically related medical bills|
|If you wish to waive enrollment in the Student Health Insurance Plan, you may complete an on-line waiver application. SHIP is not regulated or run by Cal Sports Medicine. Please read the SHIP FAQ for a full explanation.|
|For Walk On Try Outs, print and have your medical provider complete our Physical Exam Form (ONLY NECESSARY IF PARTICIPATING IN A TRYOUT).|