Student-Athlete Insurance/Pre-Participation Physical
School Year 2015-16
Welcome to Washington State University Athletics! Athletic Training Services provides medical care to student-athletes for athletic-related injuries while they are competing for WSU. WSU Athletics has an excess medical insurance policy that covers student-athletes in the event of an athletic-related injury after primary and secondary (if applicable) insurance pays on the claim. Student-athletes will NOT be able to practice until the following information has been received and the student-athlete has been cleared by the WSU training staff and physicians.
Below is a list of forms to be completed and returned to Kim Schlake with a copy of the front and back of your Health Insurance Card(s) (primary & secondary), Prescription Drug Card and Dental Card. See below for return options.
All WSU Student-Athletes:
(Parent(s)/guardian(s) must sign most of these forms for any student-athlete under 18)
Note: The below documents work best in Google Chrome, Safari and Internet Explorer.
- ► General Information
- ► Insurance Information
All students are encouraged to have insurance. All International students with F1 and J1 visa status who are enrolled at WSU are automatically enrolled in the WSU "iSHIP" (International Student Health Insurance Plan)
- ► Assumption of Risk and Release of Liability
- ► Medical Treatment Authorization
- ► Disclaimer of Protected Health Information
- ► Disclaimer of Protected Health Information (NCAA & Pac-12)
- ► Statement of Nutritional Supplements/Performance-Enhancing Substances
- ► Understanding Concussions
- ► New/Transfer Student-Athlete Medical Examination
WSU Athletic Training will provide the actual physical when you arrive in Pullman
- ► Sickle Cell Testing
WSU Athletic Training must have this information as soon as possible. You will not be able to practice with your team until this information has been received and completed!
Return forms by any of the following
Fax 509-335-4729 Attn: Kim Schlake
Mail forms to: Kim Schlake, Insurance Coordinator - ATS
Washington State University - Athletics
P.O. Box 641602
Pullman, WA 99164-1602
Scan/PDF Email: firstname.lastname@example.org
Questions: please email or call Kim Schlake: email@example.com or 509-335-7292.