Bethel University
Bethel University Medical Eligibility Forms
Athletic Medical Eligibility Forms
INSTRUCTIONS FOR FILLING OUT MEDICAL ELIGIBILITY FORMS
Dear Bethel University Student-Athlete and Parents,
We hope this letter finds you well and remaining healthy as your sport seasons quickly advance. If you have not already begun training and getting in shape, please begin preparing your mind and body to do so. Our highest incidence of injury occurs in the pre-season, most often contributed to out of shape or ill-prepared athletes.
This year the medical and insurance forms for varsity athletic eligibility will be available on-line.
You may access the packet at www.bethel.edu/athletics. The packet is divided into three separate .pdf files.
1. Medical Evaluation Form and Instructions (to be downloaded by all athletes) - Click to Download
2. Insurance Form (to be downloaded by all athletes) - Click to Download
If you are unable to download these files please email (chad-osgood@bethel.edu) or call Chad Osgood, Head Athletic Trainer (651) 638-6535. Return any completed forms PRIOR to the start of pre-season by mailing them to:
Bethel University Health Services
3900 Bethel Drive #2310
St. Paul, MN 55112
ATTN: Karen Leigh
It is recommended that you make a copy of your forms prior to mailing them to the above address and bring the copy with you when come to Bethel. The Bethel University Athletic Training Staff is not responsible for lost or misdirected forms. DO NOT mail your forms to your head coach as this will delay the completion of your file. Be advised that FAILURE to return the forms to the Health Services will delay your ability to participate in your desired sport. In other words, NO FORMS= NO PLAY.
All forms must be read and signed by the participating athlete unless the athlete is under the age of 18. If the athlete is under 18 then the form must be read and signed by the athlete's parent or guardian. The insurance form must be signed by both the athlete and the insurance policy holder.
All medical forms must be completed and turned into Bethel University Health Services prior to any participation in varsity athletics. This includes games, practices, and non-traditional seasons.
Medical Evaluation Form
This form is required by all first time athletes. The first page is made up of two halves. The left half must be completed by the athlete. The right half must be completed by the attending physician. The right side may be completed by either a MD, DO, PA, or RNP. The second page must be read and signed by the athlete.
*note - athletes who are unable to schedule a physical prior to arriving on campus have the option of getting one at a local urgent care facility. The typical cost for a physical is around $50.00. This should be used only as a last resort since your primary physician most likely has a better record of your previous health condition.
Insurance Form:
Please note, all Bethel University student-athletes must provide evidence of insurance that includes coverage for athletically-related injuries. This is a pre-requisite for practice and competition. No student will be allowed to participate in any way until such evidence of current insurance coverage is on file with the Bethel University department of athletics. The Acknowledgement of Insurance Requirements form and an insurance card, or photocopy of both sides, must be on file before a student can participate.
Insurance coverage must have a limit of at least $75,000 and cover athletically-related injuries.
If your insurance does not meet these requirements, Bethel University will review the individual
circumstances to determine if the insurance meets the insurance coverage requirement.
Bethel University will assume no responsibility whatsoever for the payment of, or authorization to pay, medical expenses resulting from injuries that occur while participating in intercollegiate athletics at Bethel University.
If you have questions regarding the terms of your coverage, you should contact your insurer immediately. Please be sure to note if there are any exclusions in your policy regarding athletically-related injuries.
The NCAA's Catastrophic Injury Insurance Program covers student-athletes who are catastrophically injured while participating in a covered intercollegiate athletic activity (subject to all policy terms and conditions). The policy has a $75,000 deductible. This coverage does not qualify as the basic coverage required for participation in athletics at Bethel University. It is supplemental coverage in the event of a catastrophic injury. More information on this program can be found on the NCAA's web-site at www.ncaa.org.
Health History Update Form:
This form is required by all returning athletes every year who already have a physical on file with Bethel University Health Services. All questions must be answered and must be signed by the athlete.