Fill out under attachments in SWOL; Please sign whether yes or waiving
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1 Dear Incoming Student-Athlete, Welcome to St. Olaf College and St. Olaf Intercollegiate Athletics. My name is Dr. Bridget Spooner and I am the Director of Sports Medicine and Athletic Training Services/ Head Athletic Trainer. Below will provide you clear instructions to walk you through medical clearance forms prior to starting as a student-athlete: 1. Create or update required information on electronic medical record system, SportsWare Online (SWOL), complete forms in attachment area of SWOL, and complete NCAA education requirements. Medical Information SportsWare Online Access (SWOL) Incoming Student-Athletes Create an Account from Instructions on website or coach s . ATC will confirm and give you access Fill in Asterisks on SWOL Asterisks are required information must be filled in Upload New Insurance Card in SWOL Complete under insurance tab Pre-Participation Examination (Physicals) Print 2-page form attached in this , under attachments tab of SWOL, or Sports Medicine Website; mail, fax, or Head Athletic Trainer once complete; must be signed by physician** not a PA or nurse Health History Questionnaire 5 pages long under attachments ; Make sure to explain ALL yes checked boxes NCAA Mental Health Forms Fill out under attachments in SWOL ADD/ ADHD Forms Fill out under attachments in SWOL: Please sign whether yes or no; if yes, use form to notify doctor of what paperwork requirements are necessary Sickle Cell Forms Fill out under attachments in SWOL; Please sign whether yes or waiving information. Please provide copy of test results to Head Athletic Trainer Student Account Charge Form Fill out under attachments in SWOL; This is for medical supplies that you might sign out for an injury/illness and do not return by the end of the year. You will be charged if items loaned are not returned. Allina Health System Fill out under attachments in SWOL; This form allows the sports medicine team, Allina Health, and our Team Physician to communicate for medical treatments, when medically necessary FERPA Release Form Fill out under attachments in SWOL Acknowledgement of Insurance Form Fill out under attachments in SWOL Pre-Season Information Packet Fill out under attachments in SWOL; Please read this document and check/ sign at end Education Yes: Watch NCAA Concussion Video: ( ), Sickle Cell Video: ( ), and read attached handouts at the end When arriving on-campus You will take ImPACT and complete baseline balance test You have to have all of the above information filled out and signed prior to participation in your sport(s). You will have the opportunity to meet with the athletic trainer(s) prior to participation in your sport(s) for questions. The athletic trainers will also present on the information in the pre-season packet during pre-season meetings.
2 2. Joining SportsWare Online (SWOL) To enter your information, visit The first time you visit the website you will need to enter your address (preferably your St. Olaf ) and click Get Password. Instruction Go to Example Look on the right side of the screen and click the Join SportsWare button. Enter your School ID: stolaf NOT your numerical School ID stolaf Enter your First Name Last Name address Choose St. Olaf College group Click the Send button. Your request to join SportsWare will then be sent to the Athletic Trainer for review. The athletic trainer will then accept this. It could take 1-3 days for the athletic trainer to approve this. Please be patient. 3. Setting Password for SWOL: Once your request is accepted log onto your and you will receive an with the Subject SportsWare request accepted. If you did not receive an check your SPAM folder. Open the and click the link to continue to SportsWare OnLine to set your password. Enter your address, new password and click the Save button.
3 4. Filling out Information on SWOL: Instruction Go to Example Enter your Address & password then click the Login button. This is your dashboard. Input your Information. Complete the following tabs: General Address Emergency Insurance o Upload Insurance Card Medical (Tetanus Shot Date) Complete all fields with an asterisk (*) Attachments Tab. Fill out the following 9 forms in SWOL: Health History Questionnaire NCAA Mental Health Form ADD/ADHD Form Sickle Cell Form Student Account Charge Form Allina Health System Form FERPA Release Form Acknowledgement of Insurance Form Read & Fill out Pre-season Information Packet and complete education listed under #1 on page one of this form. Click SUBMIT and SAVE, if you do not complete all required fields it cannot be submitted and are therefore not complete. You can always sign onto SportsWare to check your status: Just click MY INFO tab to view your forms and status as to whether information is incomplete. Do not be worried once everything is submitted/filled out and the Cleared to Play : status says no. Remember, you are not officially cleared because you still need to submit your physical form signed by a physician, take and pass ImPACT test, and complete the balance test. For any questions, call me at: Bridget Spooner DAT, ATR, ATC, CES, ITAT spoone1@stolaf.edu Fax: Cell Phone:
4 Dr. Bridget Spooner, DAT, ATR, ATC, CES, ITAT Head Athletic Trainer Cell (315) Fax (507) PRE-PARTICIPATION PHYSICAL EXAMINATION St. Olaf Sports Medicine The physical examination must be performed and signed by a M.D. or D.O. This is an NCAA requirement to participate in Intercollegiate Athletics. Please be sure to attach immunization records. Name: Date: Date of Birth: Sport(s): MEDICAL EXAMINATION: Blood Pressure: Temperature: Height: Vision: L R Resting HR: Pulse: Weight (lbs.): Corrected: Simultaneous Femoral/Radial Pulse: Ferritin*, Other labs: Uncorrected: *Consider a ferritin check for all endurance athletes (cross-country runners, Nordic skiers, distance swimmers, and distance runners) and vegetarian athletes. PHYSICAL EXAMINATION: Please list as x/20 for vision. NORMAL ABNORMAL Explain, if abnormal NORMAL ABNORMAL Explain, if abnormal GENERAL: Appearance ABDOMEN: Affect Organs Skin Masses Marfan Stigmata Tender Nutritional Status Hernia (inguinal) HEENT: MUSCULOSKELETAL: Head Neck Anisocoria Shoulders Eyes Elbows PERRLA Wrists/Hands Fundi Back Ears Hips (Hip Impingement) Nose Quads/Hamstrings Mouth Knees Throat Ankles Feet NECK: Bruits NEURO: Nodes UE/LE myotomes, dermatomes, reflexes Thyroid FEMALES: HEART: Breast Exam Rhythm Pelvic Murmur (standing) MALES: Murmur (supine) Testicular Murmur (Valsalva) ANY ADDITIONAL LUNGS: INFORMATION:
5 NCAA, Bethesda, & American Heart Association Cardiovascular Pre-Participation Screening for Competitive Athletes The cardiovascular physical examination must emphasize (but not necessarily be limited to): PERSONAL HISTORY 1) Exertional chest pain/discomfort? Yes No 2) Unexplained syncope/near syncope? Yes No 3) Excessive exertional and unexplained dyspnea/fatigue associated with exercise? Yes No 4) Prior recognition of a heart murmur? Yes No 5) Elevated systemic blood pressure? Yes No FAMILY HISTORY 6) Premature death (sudden and unexpected or otherwise) before 50 y of age resulting from heart disease in 1 relative Yes No 7) Disability from heart disease in a close relative <50 y of age Yes No 8) Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, Long QT syndrome or other ion channelopaththies, Marfan syndrome, or clinically important arrhythmias Yes No PHYSICAL EXAMINATION 9) Heart murmur (auscultation should be performed in both supine and standing positions or with Valsalva maneuver) Yes No 10) Femoral pulses to exclude aortic coarcation Yes No 11) Physical stigmata of Marfan syndrome Yes No 12) Brachial artery blood pressure (sitting position) preferably taken in both arms: / Yes No When cardiovascular abnormalities exist on the history or examination, the Bethesda conference guidelines states the athlete must be tested or referred to a cardiologist for evaluation. (ex. an EKG and echocardiogram for any prior syncope/fainting) Please provide test results and a clearance note. OTHER TESTS OR INFORMATION THE PHYSCIAN FEELS IS NECESSARY TO NOTE: CLEARANCE (PLEASE CHECK ONE): Cleared for FULL participation without restrictions. Cleared AFTER completing evaluation/rehabilitation for NOT cleared for: collision strenuous contact moderately strenuous non-contact non-strenuous **Due to Recommendations Physician Signature Date Phone ( ) - **** MD or DO MUST sign this form**** PHYSICIAN NAME AND ADDRESS:
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