PENN STATE BEHREND COLLEGE SPORTS MEDICINE
GENERAL POLICIES AND PROCEDURES FOR STUDENT-ATHLETES
This document outlines the rights and responsibilities of student-athletes regarding athletic health care. It
is imperative that the student-athlete read and understand this information so that they know what to
expect and what is expected of them in the event they suffer an injury or illness.
SPORTS MEDICINE STAFF: Refers to the certified athletic trainers, physicians and other health care
personnel utilized in the health care of Penn State Behrend College student-athletes.
I. MEDICAL ELIGIBILITY
A. All student-athletes must pass a pre-participation physical examination administered by the Penn State
Behrend College Sports Medicine Staff. Physical examinations performed by the athlete’s personal physician
are not acceptable. It must be clearly understood that ALL intercollegiate athletes must receive this medical
clearance before participation. The signature of the examining physician on the pre-participation
examination form will present evidence of this medical authorization.
B. The student-athlete’s primary medical insurance information MUST be on file with the Sports Medicine Staff
prior to taking the physical examination. Students who fail to produce this information will be prohibited
from taking a physical examination and thus prohibited from participating in Athletic Department sponsored
practices or competitions.
C. Athletic physical examinations are in effect for one year. The Sports Medicine Staff may re-examine or
change the medical participation status of any athlete at any time during the athlete’s career at Penn State
Behrend College.
D. A medical history is required from each athlete prior to taking a physical examination. Failing to document
any previous or existing medical condition on this history form will release Penn State Behrend College from
all financial liability for the unreported problem(s) and any subsequent related problems. IF ANY TESTS, XRAYS OR REFERRALS ARE REQUESTED BY THE BEHREND SPORTS MEDICINE STAFF AS A RESULT OF FINDINGS
DURING THE PHYSICAL EXAMINATION, FINANCIAL RESPONSIBILITY FOR THESE RESTS SOLELY WITH THE
ATHLETE AND THEIR PERSONAL HEALTH INSURANCE.
E. Previous injuries, not fully rehabilitated, may disqualify any athlete from participation until approved by the
Behrend Team Physician or consulting orthopedists. If a student-athlete is under care of a physician not
associated with Penn State Behrend College, written permission must be presented to the Sports Medicine
Staff stating the nature of the injury and the date the student may resume activity.
F. The Behrend Sports Medicine Staff may disqualify any athlete who has any condition for which participation
in their chosen sport is contraindicated.
II. MEDICAL POLICIES FOR ATHLETES
A. It is the responsibility of the student-athlete to maintain a reasonable level of health. This means it is their
responsibility to take proper care of themselves---including proper diet, fitness and sleep as well as avoiding
behaviors that are potentially dangerous.
B. The athlete should promptly report all injuries and illnesses to a staff athletic trainer. Injuries/illnesses not
noted during participation should be reported immediately after the practice/game or between the hours of
11:00 AM and 2:00 PM the next day. Failure to report a condition within three days results in the release of
Penn State Behrend College from any financial responsibility for medical expenses for that condition.
C. In case of emergencies occurring outside of regular hours, contact a staff athletic trainer, the Behrend Health
and Wellness Center or call 911.
D. All treatments will be given under the direction of a staff athletic trainer who works under the supervision of
the Behrend Team Physician.
E. Decisions concerning participation status shall be solely at the discretion of the Penn State Behrend College
Sports Medicine Staff.
III. MEDICAL REFERRAL POLICIES
A. Except in emergencies, a staff athletic trainer MUST screen all conditions prior to referral to a team physician
or other consultant.
B. The Sports Medicine Staff will make referral appointments. Transportation to medical facilities/offices
located off-campus will be provided by the Sports Medicine Staff ONLY if the athlete is unable to arrange
personal transportation.
C. All orthopedic evaluations will be done for the Department of Athletics through associated consultants of St.
Vincent’s Sports Medicine. This policy assures proper and immediate care, close follow-up treatment and
smooth injury management for the student-athlete and the Behrend Sports Medicine Staff.
D. If a student-athlete desires a second opinion, the student-athlete is required to request a referral form,
which must be updated by the physician and returned to the Sports Medicine Staff before consideration of
resumption of activity is allowed.
E. A consultation between the parents of any athlete and the Behrend Sports Medicine Staff will be arranged
whenever requested. All decisions regarding medical approval or disqualification in the intercollegiate
athletics program will be made solely the Behrend Team Physician and/or associated consultants.
F. The Behrend Sports Medicine Staff reserves the right to require referral to an outside medical agency for the
evaluation, treatment and/or rehabilitation of any problem not related to athletics.
G. Any student-athlete incurring an illness at a time outside the dates of traditional or non-traditional seasons,
may be required to report to the Penn State Behrend College Health and Wellness Center for treatment.
IV. MEDICAL EXPENSE PAYMENT POLICIES
A. All participants are required to show proof of medical insurance prior to having a physical examination. This
policy must provide benefits for athletic related injury. A front and back copy of the participant’s primary
insurance card must be on file before the student-athlete will be allowed to participate in any practice or
competition.
Student-athletes whose families do not have an insurance plan are encouraged to purchase an insurance
package that does not exclude NCAA intercollegiate athletic sports injuries.
B. Penn State Behrend College will ONLY be financially responsible for injuries occurring while an athlete is
representing the College in formal intercollegiate activity, which is supervised by a coach. Care for illnesses
such as colds, flu, etc. will only be covered during a sport season in which the athlete is engaged in formal
full-team practices supervised by a coach.
C. Penn State Behrend College’s Athletic Department requires that bills be submitted first to the primary
health insurance company of the athlete and his/her parent or guardian. Penn State Behrend College
retains a secondary excess policy in conjunction with The Pennsylvania State University’s Department of Risk
Management. This secondary policy will pay ONLY AFTER primary insurance has been engaged and only for
athletic-related injuries.
D. The Sports Medicine Staff will handle acute care and rehabilitation of minor injuries at no cost whenever
possible. The Sports Medicine Staff will see that individual student-athletes receive the best treatment
available while following the guidelines of his/her primary health insurance policy. It is the responsibility of
the student-athlete to inform the Sports Medicine Staff of any peculiarities and changes in his/her medical
insurance coverage (i.e. HMO, PPO). If services are rendered while there is a lapse in coverage, the student–
athlete will be responsible for all charges incurred during this lapse. Please let the Sports Medicine Staff
know of any questions that may arise concerning the medical coverage of a student-athlete.
E. Arrangements for follow-up care with a physician for injuries incurred during athletic activity must be
completed within a 14 day period after completion of the competitive season, eligibility or termination from
the team. After said period, Penn State Behrend College is no longer financially responsible for any
expenses incurred as a result of said injury, unless other arrangements have been made with the Sports
Medicine Staff.
CONTACT NUMBERS FOR SPORTS MEDICINE STAFF
JEFF WEBSTER ATC---HEAD ATHLETIC TRAINER
(office) 814-898-6340
Email jxw63@psu.edu
ANGE MESEROLE ATC---ASSISTANT ATHLETIC TRAINER
(office) 814-898-7227
Email amm43@psu.edu
JEFF HAFT ATC---ASSISTANT ATHLETIC TRAINER
(office) 814-898-6017
Email jmh73@psu.edu
ST. VINCENT’S SPORTS MEDICINE
814-835-2035
ST. VINCENT’S MEDICAL CENTER EMERGENCY ROOM
814-452-5353
PENN STATE BEHREND HEALTH & WELLNESS
814-898-6217
ATHLETIC TRAINING ROOM POLICIES AND PROCEDURES FOR ATHLETES
 Athletic Training Room Hours:
o M-F: 2:00 PM – 7:00 PM (or until last practice ends)
o SAT-SUN Pending scheduled practices/events
For practices/competitions outside of these hours, the facility will open 1 hour prior to the time the team
is required to report, or as specified by the staff athletic trainer.
o Morning times (prior to 2 PM) are by appointment for prescribed rehabilitation.
 The Athletic Training Room is a co-ed facility. Proper dress is required for treatment. Please wear shorts
and a t-shirt at all times.
 Showers are MANDATORY before receiving post-practice/post game treatments.
 Treatments are available to intercollegiate athletes only; in season athletes have priority.
 Injuries not sustained during intercollegiate functions are not the responsibility of the Sports Medicine
Staff. Treatment of these injuries will not be the responsibility of the Sports Medicine Staff.
 The Athletic Training Room operates on a first-come first-serve basis. Come early if you want to avoid the
rush.
 You are responsible for getting your taping or treatments done in time for all meetings and practices.
Remember you are never late for practice because you were detained in the Athletic Training Room, you
simply did not arrive early enough. EXPECT THE ATHLETIC TRAINING ROOM TO BE BUSY!
 Team physicians will be available periodically in the Athletic Training Room. Athletes must see a Sports
Medicine Staff member prior to seeing a physician in the Athletic Training Room.
 Athletes must check in with an athletic trainer prior to beginning treatment or using any equipment.
 Appropriate treatment for any and all musculoskeletal injuries will be decided on only by a Sports
Medicine Staff member. When necessary (as deemed by the athletic trainer), the team physician will be
involved.
 Continue all treatments until the staff athletic trainer releases you. Do not stop treatments just because
your injury feels better. If you miss a treatment, you will be assumed to be healed, and thus okay to
practice.
 Taping will be performed only as deemed necessary by the Sports Medicine Staff. Taping must be
accompanied by prescribed exercise. Braces may be utilized in lieu of routine taping at the discretion of
the Sports Medicine Staff.
 No athlete is permitted to operate athletic training room equipment --- No Self Treatments.
 All equipment is to stay in the Athletic Training Room unless issued by a staff member. Student-athletes
will be billed for equipment not returned unless specified by a staff member. Failure to remit payment for
equipment not returned will result in records being placed on hold by the College.
 No food or drink please.
 The facility is not to be used as a lounge or place to socialize. NO LOITERING.
 No form of harassment, sexual or otherwise, will be tolerated. This includes language, gestures or implied
comments.
 Individuals not abiding by these policies will be asked to leave the facility, refused service and/or will be
reported to the respective head coach and athletic director for disciplinary action.
 Finally and most importantly, COMMUNICATE WITH YOUR ATHLETIC TRAINERS!!!! We are here to help
you, not hinder you.
PENN STATE ERIE, THE BEHREND COLLEGE
ATHLETIC DEPARTMENT/SPORTS MEDICINE SERVICES GENERAL POLICIES
1. Risk of Injury: Intercollegiate athletics may constitute a dangerous activity involving the risks of injury. Those
dangers and risks of playing or practicing include, but are not limited to death, severe neck and spinal injuries,
which may cause complete or partial paralysis, brain damage, severe internal injury, severe injury to bones,
joints, ligaments, muscles tendons and other aspects of the musculoskeletal system. It is understood that such
injury may result in serious impairment of future abilities to earn a living, to engage in other businesses and
generally enjoy life.
2. General Policy Statement: Our purpose is to provide the best medical care possible for all athletes. Penn
State Erie, The Behrend College Athletics carries medical insurance for all injuries directly related to participation
in practice or university sponsored athletic competition. We will act as the secondary providers while your
personal or parents insurance will act as the primary coverage in such events. It is strongly recommended that
you or your parents carry insurance to cover any non-athletic injuries or illnesses since these are not covered by
Penn State Erie, The Behrend College.
3. NCAA Bylaws Section 16.4: According to NCAA rules, only sickness or injury directly related to participation in
intercollegiate athletics may be financed by the member institution. If sickness or injury occurs in classes,
outside of class, or in extra-curricular activities that are not athletically related, it cannot be financed by the
member institution. If an athlete enters the institution with a pre-existing injury or condition, the member
institution will not finance any medical expenses for that injury/condition.
4. All Student-Athletes: In order for any student-athlete to participate in intercollegiate athletics while enrolled
at Penn State Erie, The Behrend College, proof of primary medical insurance coverage must be provided. All
costs for medical treatment, which results from injuries sustained while participating in intercollegiate athletics,
must be covered by a primary health insurance plan. In order to take the pre-participation physical exam, all
student-athletes must provide Sports Medicine Services with proof of this insurance. Proof of insurance shall
include a specific insurance company and policy number.
5. Medical Referrals: If you see a doctor without proper authorization, you will incur all responsibility for
expenses.
6. Dental & Eye Care: Only dental and eye injuries directly related to intercollegiate athletics participation can
be financed by Penn State Erie, The Behrend College. All other problems should be reported to Sports Medicine
Services for proper referral.
7. Problems at Night & Emergencies: When the athletic training room is closed and you need the
services of the Sports Medicine Staff, call the athletic training room at 898-6340, 898-7227 or 898-6017.
If you are unable to reach the athletic trainer and your emergency is severe, try to contact your head
coach and go to the nearest hospital emergency room. However, you must notify the Sports Medicine
Staff the following morning.
STUDENT-ATHLETE AUTHORIZATION/CONSENT FOR DISCLOSURE OF
PROTECTED HEALTH INFORMATION TO THE NATIONAL COLLEGIATE
ATHLETIC ASSOCIATION
I,
hereby authorize Penn State Behrend College
Name of Student-Athlete
and its physicians, athletic trainers and health care personnel to disclose my protected health
information and any related information regarding injury or illness during my training for and
participation in intercollegiate athletics to the National Collegiate Athletic Association (NCAA)
and its employees or agents.
I understand that my protected health information will be used only by the NCAA’s Injury
Surveillance System (ISS) for the purpose of conducting research on injuries resulting from
training for or participating in athletics. The ISS is a longitudinal research database that provides
the NCAA, NCAA sports rules committees, athletic conferences, researchers and individual
schools with summary (aggregate) injury and participation information that does not identify
individual athletes or schools. The summary data provide the Association and other groups with
an informative resource upon which to base health and safety rules and policy and to examine
the effectiveness of such efforts.
I understand that my injury/illness information is protected by federal regulations under either
the Health Information Portability and Accountability Act (HIPAA) or the Family Educational
Rights and Privacy Act of 1974 (the Buckley Amendment) and may not be disclosed without either
my authorization under HIPAA or my consent under the Buckley Amendment. I understand that
my signing this authorization/consent is voluntary and that Penn State Behrend College will not
condition or withhold any health care treatment or payment, enrollment in a health plan or
receipt of any benefits (if applicable) on whether I provide the consent or authorization
requested in this disclosure. I also understand that I am not required to sign this
authorization/consent in order to be eligible for participation in NCAA athletics.
I understand that HIPAA regulations do not apply to the NCAA’s use or disclosure of my
injury/illness information, the NCAA is committed to protecting my privacy. I understand that the
protected health information will be encoded before being transmitted from Penn State Behrend
College to the NCAA and that neither the NCAA nor the ISS will identify me personally in any
publication or disclosure of research results. Data will be stored on a secure server at the NCAA
national office in Indianapolis, Indiana.
This authorization/consent expires 380 days from the date of my signature below, but I have the
right to revoke it in writing at any time by sending written notification to the athletic director or
athletic trainer at Penn State Behrend College. I understand that a revocation takes effect on its
request date and does not affect any action taken prior to that date.
***See page 9 of this packet for authorizing signature.*
***
PENN STATE BEHREND COLLEGE ATHLETIC DEPARTMENT
ASSUMPTION OF RISK FORM
(SHARED RESPONSIBILITY FOR SPORT SAFETY)
A statement of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports-August 1978/reissued March 1979
Participation in sports requires an acceptance of risk of injury. Athletes rightfully assume that those
who are responsible for the conduct of sports have taken reasonable precautions to minimize the risk
of significant injury. Periodic analysis of injury patterns continuously leads to refinement in the rules
and/or safety guidelines. However, to legislate safety via the rule book and equipment standards,
while often necessary, is seldom effective in and by itself. To rely on officials to enforce compliance
with the rulebook is as insufficient as to rely on warning labels to produce behavioral compliance
with safety guidelines. Compliance means respect everyone’s part for the intent and purposes of a
rule or guideline, not merely technical satisfaction with some of its phrasing.
Some sport safety problems lend themselves readily to identification and solution (e.g. heat stroke
and administration of liquid freely during early football practice). Some safety problems may be less
clearly identified (e.g. head injuries) and solutions may be developed on selective assumptions and
the premise that measurable standards are better understood than qualitative rhetoric (e.g.
purchase a helmet manufactured in accordance with NOCSAE standards instead of purchasing the
“best helmet possible”). Some safety problems remain problems because of questionable
compliance with legislated solutions (e.g. dental mouth guards).
The athlete should be acquainted with the risks of injury respective to their specific sport and
knowledgeable concerning the rules and practices they are employing to minimize his/her risk of
significant injury while pursuing the many benefits of sports. The student-athlete and the Athletic
Department at Penn State Behrend College have a mutual need for an informed awareness of the
risks being accepted and for sharing the responsibility for controlling these risks.
At Penn State Behrend College, every effort is made to control the risk of injury. The Sports Medicine
Staff participates in the NCAA Injury Surveillance System for a number of sports in order to examine
trends in athletic injury. Once trends have been identified, steps are taken to control the risks and
causes of these trends. In addition, the latest strength and conditioning techniques are employed,
realizing that a well-conditioned athlete has a lower risk of injury.
Even with the current programs and techniques being employed, it should be understood that a
certain amount of injuries will occur, including the possibility of catastrophic injury, or even death.
The student-athlete and his/her parents should be cognizant of this fact and understand that at Penn
State Behrend College, every possible step is being utilized to make sports participation as safe as
possible.
I certify that I have read and understand the above statement and agree to accept the shared
responsibility for my safety as a student-athlete at Penn State Behrend College.
***See page 9 of this packet for authorizing signature.*
***
PENN STATE ERIE, THE BEHREND COLLEGE SPORTS MEDICINE SERVICES
AUTHORIZATION FOR ROUTINE RELEASE OF INFORMATION
The undersigned student-athlete or authorized representative requests and authorizes
Penn State Erie, The Behrend College Department of Athletics to release routine studentathlete’s athletic health information as described below.
A. Health Information to be released. I am authorizing release of routine health and injury
information. Routine health and injury information includes information pertaining to
injuries occurring during practice, games, competitions and other sanctioned Penn State
Erie, The Behrend College athletic events.
a. Recipient: This authorization is valid for release of information to the media,
including local and national media, Penn State Erie, The Behrend
College’s Public Relations and student media.
B. Purpose. Penn State Erie, The Behrend College’s Department of Athletics is seeking this
authorization in order to coordinate in advance, the management of each student-athletes’
health information.
C. Expiration. This authorization expires one year from the date signed.
D. Explanation of Rights. I, as student-athlete/student representative, understand that:

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I may refuse to sign this authorization for routine disclosures.
I have the right to revoke this authorization at any time, provided that I submit my
written revocation to the Head Athletic Trainer, Penn State Erie, The Behrend
College, 5103 Station Road, Erie, PA 16563.
Any revocation of this authorization does not apply to disclosures already made by
Penn State Erie, The Behrend College in reliance of this authorization or for
disclosures otherwise required by law.
I have the right to review my Athletics Department health records before signing this
authorization.
It is possible that the person/entity authorized by my signature to receive the above
health record(s) has no duty to protect the confidentiality of records disclosed to
them. There is a risk that the recipient may re-disclose the information.
E. Authorization.
I HAVE READ AND UNDERSTAND THIS FORM. I AM SIGNING IT VOLUNTARILY. I AUTHORIZE
THE DISCLOSURE OF MY PENN STATE BEHREND COLLEGE ATHLETICS’ HEALTH INFORMATION
AS DESCRIBED IN THIS FORM.
***See page 9 of this packet for authorizing signature.*
***
PLEASE COMPLETE ALL THE INFORMATION ON THIS PAGE
Name:
Last
First
M.I.
Sport:
Please read this very carefully. If you have any questions, please bring them
to our immediate attention.
We, the undersigned, have read and understand all the forms listed below. By checking
the following boxes and affixing our signatures below, we agree to follow the policies
and procedures set forth by the Penn State Behrend Sports Medicine Department and
the Penn State Behrend Athletic Department. We understand that failure to adhere to
these policies and procedures may result in delays for insurance claim payments, delays
in release of medical information and/or my being barred from using the Penn State
Behrend Sports Medicine Staff and Athletic Training Facilities.
NCAA HIPAA Form
Assumption of Risk Form
Authorization for Routine Release of Information Form
Athletic Department General Policies Form
Athletic Training Room Policies and Procedures for Athletes Form
General Policies and Procedures Handbook
_____________________________________________
Student Athlete Signature
____________________
Date
Please return this page only along with a completed copy of the Athlete Insurance / Medical History
Forms to the following address:
Sports Medicine/Athletic Training Services
Penn State Behrend College
5103 Station Road
Junker Center
Erie, PA 16563-0400