Intercollegiate Athletes Health Forms
Instructions for Intercollegiate Athletes, Club Rugby and Club Crew
Students planning to participate in intercollegiate sports at any level (Varsity or JV) or Club Rugby or Club Crew must complete the standard Middlebury College Student Health Form and must comply with additional NCAA and Department of Sports Medicine requirements.
The information below will guide you through this process. Please read all of this information carefully.
Middlebury College Athlete Supplemental Health Form
In addition to the Middlebury College Student Health Form, students participating in these sports must complete the supplemental form below:
Complete the front page of this form prior to your physical exam. Take all of these forms, including the Athlete Preparticipation Physical Examination Form (found below) to your health care provider.
Your health care provider must complete and sign the back page of the Supplemental Form titled Athletic Clearance. Your provider must use the Athlete Preparticipation Physical Examination Form to guide that assessment. Your provider keeps the Athlete Preparticipation Form in his or her records. You do not need to send a copy of it to us.
Return the Athlete Supplemental Health Form with your Middlebury College Student Health Form to Parton at the following address:
Parton Center for Health and Wellness
14 Old Chapel Road
Middlebury, VT 05753
NCAA 6-month Rule
Your physical exam must meet the NCAA 6-Month Rule. Athletic physicals are not provided by Parton Health Services or the Department of Sports Medicine and can be difficult to arrange quickly in the Middlebury area. Having the Middlebury College Student Health Form and the Athlete Supplemental Health Form completed on time and following team instructions will allow most students to meet this rule. More information is available at:
NCAA Rule on Sickle Cell Trait Testing
Beginning in August 2013, new NCAA legislation requires that schools must confirm the sickle cell trait status of incoming student-athletes before participation in intercollegiate athletics. More information is available at:
NCAA rule on medical exceptions for banned substances, including ADD/ ADHD medications
Students athletes must comply with the NCAA rule on medical exceptions for banned substances, including medications for stimulants used to treat ADHD/ ADD, male-pattern baldness, peptide hormones (human growth hormone), and anabolic steroids (testosterone). The student athlete must have on-file at the college complete documentation including a letter signed by the prescribing physician that includes all pertinent physical and psychological tests related to the diagnosis and treatment of the condition. Information will be sent to you from your coach with instructions on how to comply with this rule. More information is available at:
NCAA Annual Health Update and Sickle Cell Form
Every student trying out for an intercollegiate, varsity or JV program and club rugby and crew must complete the NCAA Annual Health Update and Sickle Cell process. These forms are available in the student health portal. Information about setting up a student portal account and completing the clearance process is available at this link: http://www.middlebury.edu/studentlife/services/health/sportsmed/all