All Northwest University athletes are required to complete the following forms before sport practice starts. You will not be allowed to start practice until these forms have been cleared by the Athletic Trainers.
ALL FORMS ARE WRITEABLE PDFS. PLEASE DOWNLOAD AND SAVE TO YOUR COMPUTER AND THEN SEND THEM VIA EMAIL. Please refrain from copy & pasting to Word Documents as this messes up the formatting and the forms do not come out the same.
New Athletes Medical Eligibility Packet (New and Transfer Student-Athletes Only)
Included in this packet are the following forms in order: Emergency Contact, Insurance, and Medical Questionnaire.
Emergency Contact Information
In the case of an emergency the Athletics Department needs to have accurate information about each student athlete. The completed form will be included in the athlete’s file and also in the medical bag that travels with the team.
Northwest University provides an ‘excess’ coverage for all students, whether participating in intercollegiate athletics or events not sponsored by the Athletics Department. Each athlete must have their own primary insurance coverage in order to be eligible to participate in events (including practice or games). The completed form will also be included in the athlete’s file as well as in the medical bag that travels with them.
Pre-Participation Physical Exam Instructions
For New or Transfer student-athletes getting physicals on or off campus
- Print out the form linked below and take with you to your physical appointment with your doctor.
- After the doctor has filled it out, please scan and send to either the Athletic Trainers or Ashton Wheeler.
- You may send the hardcopy via mail to the Athletic Trainers or Ashton Wheeler.
The student-athlete is required to show evidence of having an initial physical exam with a licensed medical physician that will include clearance for all sports the athlete will participate in. You are welcome to have a physician of your choice administer this exam or you can elect to have a Northwest Team Physician administer the exam. The physical must be completed on the above form and is the only accepted form of proof that the initial physical examination has been completed. This form must be completed by a MD, DO, PA-C, or ARNP and documented with their signature, credential, office name, contact information, and date of completion. Any injuries or change in health after the date of the physical need to be reported on the Medical History form in the packet above.
Returning Athlete Medical Eligibility Packet
Returning athletes will be required to complete all forms in the following packet prior to participation in their first practice. The packet includes Emergency Contact, Insurance, and Returning Athlete Medical History forms.
Please take note: if you have had an injury or a significant change in your health since your last physical examination, it MUST be reported to the Athletic Trainer so it can be evaluated or you may not be covered for treatment of that injury or other injuries that may be related.
Return all forms – including the [Eligibility Packet Checklist] – to:
Ashton Wheeler – Athletics
5520 108th Ave NE
Kirkland, WA 98033
Email: Ashton Wheeler (firstname.lastname@example.org)
Return all forms – including the Eligibility Packet Checklist
- Accident Coverage Overview
- Accident Policy Contact List
- Excess Insurance for Athletes: Information / Claim Packet
- Excess Insurance for Students: Information / Claim Packet / Provider Information Letter