Get the free Student-athlete prescription declaration form - Temple University

STUDENTATHLETE PRESCRIPTION DECLARATION From The NCAA bans classes of drugs that can be harmful to student athletes and that can create unfair advantages during competition. Some medications that

How to fill out student-athlete prescription declaration form

How to fill out student-athlete prescription declaration form:

1. Obtain the form: The student-athlete prescription declaration form can usually be obtained from your school's athletic department or athletic trainer. It may also be available online on the school's website or through a designated portal.
2. Personal Information: Start by filling out your personal information on the form. This includes your full name, date of birth, address, contact number, and email address. Make sure to provide accurate and up-to-date information.
3. Sports details: Indicate the sport or sports that you participate in as a student-athlete. This helps the medical staff and athletic trainers determine specific requirements or precautions related to your sport.
4. Medical history: Provide details about your medical history. This may include any previous injuries, surgeries, or medical conditions that may impact your participation as a student-athlete. Be honest and thorough when filling out this section to ensure appropriate care and support.
5. Current medications: List any medications you are currently taking. Include the name of the medication, dosage, and frequency. It is crucial to disclose this information as it helps prevent any potential drug interactions or conflicts with your athletic performance.
6. Prescribing physician information: Fill in the details of the physician who prescribed the medications listed. Include their name, contact information, and any other required information. This allows the medical staff to confirm and communicate with your prescribing physician if necessary.
7. Signature: Sign and date the form to acknowledge that you have provided accurate information to the best of your knowledge. By signing, you also consent to sharing this information with the necessary medical personnel involved in your athletic care.

Who needs the student-athlete prescription declaration form?

1. Student-athletes: Any student who participates in athletic activities and is currently on prescribed medication will need to fill out the student-athlete prescription declaration form. This helps ensure their safety and well-being during athletic participation, as well as informs medical staff and athletic trainers about any necessary precautions or actions that may be required.
2. Athletic department or school authorities: The student-athlete prescription declaration form is crucial for the athletic department and school authorities to have a comprehensive understanding of the medical needs and conditions of their student-athletes. It allows them to provide appropriate medical support, ensure compliance with any relevant policies or regulations, and facilitate effective communication with healthcare providers if necessary.

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What is student-athlete prescription declaration form?

The student-athlete prescription declaration form is a document that student-athletes must fill out to declare any prescription medications they are taking.

Who is required to file student-athlete prescription declaration form?

All student-athletes participating in school sports are required to file the student-athlete prescription declaration form.

How to fill out student-athlete prescription declaration form?

Student-athletes need to list all prescription medications they are taking, the dosage, and frequency on the form.

What is the purpose of student-athlete prescription declaration form?

The purpose of the student-athlete prescription declaration form is to ensure the safety of student-athletes by alerting coaches and medical staff of any prescription medications they are taking.

What information must be reported on student-athlete prescription declaration form?

Student-athletes must report the name of the prescription medication, dosage, frequency, and the prescribing physician on the form.