Regis University Sports Medicine Forms

Welcome to Regis University!

Dear Student-Athlete,

All freshman, transferring student-athletes and walk-ons are REQUIRED to fill out all of the physical forms prior to participating at Regis University. These must be completed in full, with a front and back copy of your insurance card, and returned back to Kristin Wimp in the athletic training room by JULY 20TH!!!!  Also, all physicals must be current as of April of the same year.

International Student-Athletes:
     ALL International student-athletes are required to have United States sponsored primary insurance coverage for athletic participation. (Aetna, United Healthcare, Cigna, Blue Cross/Blue Shield).  You may utilize the Regis University student insurance or any of the other ones listed.  Any injury occurring during a Regis related event must be ran through your primary insurance first before the athletics' secondary insurance benefits will kick in.  The active date for this insurace must be before August 1st prior to the beginning of the first practice as a Regis student-athlete.  The policy must have 12-month coverage.   

Below is a list of all of the required paperwork needed, which can be found with the links below. MAKE SURE TO READ ALL OF THE INSTRUCTIONS!

     1. Student-Athlete Medical Info Sheet.
     2. Preparticipation Physical Evaluation History Form (make sure to explain “yes” answers in right hand corner of the sheet or it will be incomplete). Also, sign and date the bottom.
     3. Preparticipation Physical Evaluation Physical Examination Form/Clearance Form which is filled out by the physician and signed/dated on the bottom and the clearance form to be filled out by an M.D., D.O., P.A., or L.P.N. ONLY!! The physical forms will not be accepted as completed without the physician’s stamp or business card for verification!!
     4. Preparticipation Examination Disclaimer must be signed and dated by you the student-athlete.
     5. Front and Back Copy of Your Current Primary Insurance Card
     6. Results from Sickle Cell testing or signed Sickle Cell waiver form 

Preparticipation Forms

***If you are a student-athlete taking asthma medication you are required to send a letter from your treating physician stating: that you are under their care for asthma and a list of the current medications you are taking. ***

***If you are a student-athlete that has been diagnosed with ADHD you must have the following from your diagnosing/treating physician: A clinical assessment from the physician (see attached example form), a list of current drugs you are taking, and that your ADHD is being monitored routinely!! ***

ADHD Forms

PLEASE COMPLETE AND RETURN ALL OF THE REQUIRED FORMS, BY JULY 20TH TO:

Kristin Wimp, MA, ATC
Regis University Athletics
3333 Regis Blvd. F-20
Denver, CO 80221-1099

Your health is our number one priority. If you have any questions please feel free to contact me. GO RANGERS!

Thanks,

Kristin