Welcome New and Returning CSUB Student-Athletes,

The CSUB Athletic Trainer staff would like to welcome you to an exciting new school year! In preparation for the upcoming sport seasons, you will need to satisfactorily pass an annual pre-participation physical examination. As part of the physical examination, you will be providing a new and/or updated health history.

As per NCAA Sports Medicine Guidelines, new and returning student-athletes are required to complete a medical clearance procedure prior to participation in any supervised physical activities directly associated with intercollegiate athletics. A new student-athlete is defined as a freshman or transfer eligible student-athlete participating for CSUB for the first time. A returning student-athlete is defined as a student-athlete who participated in CSUB intercollegiate athletics the previous year. Here at CSUB, all student-athletes are required to have a physical examination for medical clearance by our team physician. The only accepted physical examination for medical clearance is by a physician employed by the University. (CSUB team physician and/or CSUB student health center physicians).

Our new web site will direct you to the appropriate forms. All documents (PDF format) are required to be completed online. Documents downloaded and completed by hand are not accepted. Please print the documents you completed online. If you are unable to print these documents, please contact your coach immediately. If you are under the age of 18, you are required to have you parent/guardian signature on each of the listed forms. Contact your coach for the date of your scheduled medical clearance.

On the day of your scheduled medical clearance, please bring all of your completed documents with you. Be sure all documents are completely filled out as listed on your Check- List! Be sure all signatures and/or initials are completed on each document in black ink. If you present incomplete and/or missing documents, you will be dismissed from the medical clearance process! In order for you to return to the medical clearance process, you must first complete all missing information and/or secure missing documents online. You will then be required to wait at the end of all line.

Thank You,

CSUB Athletic Training Staff

CALIFORNIA STATE UNIVERSITY, BAKERSFIELD
PHYSICAL EXAMINATION CHECKLIST

Instructions: All documents are required to be completed online prior to the sport's scheduled physical examination date. Hand written documents are not accepted. Student-athletes must print the documents completed online. All printed documents must have the student-athlete signatures and/or initials as indicated on each document. Signatures and initials must be completed in black ink. Athletes Under the Age of 18 Require Parent/Guardian Signatures.

  • New Student-Athlete History OR Returning Student-Athlete Questionnaire (All Student-Athletes must see the team physician on the day of the physical to receive clearance)
  • Emergency Information Card
  • Statement of Beneficiary
  • Authorization Waiver
  • Proof of Insurance
  • ADD/ADHD Disclosure
  • Sickle-Cell Trait Disclosure

***STUDENT-ATHLETES MISSING ANY PORTION OF THE ABOVE LIST WILL BE FORCED TO THE BACK OF THE LINE

New/Transfer Student-Athlete Physical Forms

 1. New Athlete History

  2. Emergency Card

  3. Statement of Beneficiary

  4. NCAA and CSUB Policies

  5. Proof of Insurance

   6. ADD/ADHD Disclosure

   7. Sickle-Cell Trait Disclosure

 8. Medical Consent and Acknowledgements

  

Returning Student-Athlete Physical Forms

 1. Returner History

 2. Emergency Card

  3. Statement of Beneficiary

  4. NCAA and CSUB Policies

  5. Proof of Insurance

   6. ADD/ADHD Disclosure

   7. Sickle-Cell Trait Disclosure

  8. Medical Consent and Acknowledgements

 

 

 

CSUB Secondary Insurance Terms and Policies