Dear Future Gaucho and Parents/Guardians:
On behalf of the UCSB Athletic Training Staff, we would like to welcome you to the University of California at Santa Barbara.
- Student-Athlete Information
- Pre-Participation Athletic Clearance Initial History (2 pages)
- Student-Athlete Orthopedic History
- Verification of Insurance (including a copy of the front and back of your insurance card). This form is required by our insurance carrier.
- Emergency Card
- Sickle Cell Results
To ensure no delays in your clearance and participation, please complete all of the forms completely.
These forms will provide us with the pertinent information related to your medical history, which will allow for a more thorough and efficient physical examination. Please answer all the questions as thoroughly and honestly as possible. Your health and safety are our first concern. All information will be handled in a confidential manner.
As of August 1, 2010, The NCAA (per Bylaw 17.5.1) mandates that its member colleges and universities determine the sickle cell trait status of all new student-athletes. In accordance with this rule, UCSB Athletic Training and UCSB Student Health has made the necessary changes to the existing sickle cell trait screening program. Under the current NCAA and UCSB Athletics rules, your son or daughter must satisfy one of the following options at the time of the pre-participation physical to be medically cleared for athletics.
1) Provide results of a prior sickle cell test
2) Take a blood test at Student Health Services (sickle cell solubility test) and await the results BEFORE participating (may take several days for results)
3) Sign a written release that declines submission of prior test results and blood testing (must be completed in person at the time of pre-participation examination)
How to provide results of previous testing:
As of today, all 50 states have newborn screening programs that identify sickle cell trait status at birth, however not all states adopted screening in the same year. In the state of California, if your son or daughter was born after February 27, 1990, results may be available from your child’s pediatrician or from the State at www.cdph.ca.gov/programs/nbs . Look for frequently asked questions from athletes for sickle cell trait. We suggest calling your pediatrician prior to submitting any request to ask if they have results on file, if not available; contact the state as noted above.
If you son or daughter was NOT born in California, please contact your pediatrician for results. Alternatively, you may contact the newborn screening program in the state where your child was born using this website: http://genes-r-us.uthscsa.edu/resources/consumer/statemap.htm
Under NCAA rules, we must be aware of your child’s sickle cell status at the time of their pre-participation exam in order to ensure the highest level of safety. Realizing that it may take up to eight weeks to obtain results, please attempt to request this information from your pediatrician or state as soon as possible. If we do not have the results available at the time of the physical, your child can be tested at Student Health Service.
We also recommend that all immunizations are up to date, including tetanus and pertussis. Along with the pre-participation forms, please send a copy of sickle cell trait screening and all immunization records. If you have had a history of any injuries, accidents, illnesses, cardiac conditions or surgeries that have kept you from participating in your sport, please provide us with a written letter of final clearance signed by the treating physician. This will expedite your physical examination, otherwise, clearance may be delayed.
The University of California Regents and UCSB Student Health Services requires all University of California students to have health insurance coverage. We highly encourage all student-athletes to purchase the UCSB Undergraduate Student Health Insurance Plan (USHIP) for the entire academic school year. By purchasing this plan, a student-athlete will have access to medical care on campus at the UCSB Student Health Center for general health issues and/or non-athletic related illness/injuries. This will be very convenient for your son or daughter without interrupting their busy academic demands and schedule. Also if you decide to purchase the USHIP policy and your son or daughter starts practices and competition prior to the start of the academic school year (September 23rd), we encourage you to purchase the USHIP Supplemental, Pro-Rated coverage. For further information concerning USHIP insurance contact a staff athletic trainer or the UCSB Student Health Service USHIP insurance web site.
Please return the completed forms, by mail, to UC Santa Barbara, ICA Building-1401 D, Athletic Training Facility, Santa Barbara, CA. 93106-5200 no later than July 15, 2012 to allow us enough time to get your medical file prepared for your student-athlete’s physical examination.
You will not be given a physical examination or be able to participate until these forms are completed and returned. If you have any questions, please feel free to contact us at (805)893-3424.
Leroy Heu, M.A., A.T.C.
Assistant Athletics Director/Sports Medicine
Head Athletic Trainer