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Pre-Participation Physical Exam

Athletic Training

Pre-Participation Packet

 

 
Pre-Participation Physical Exams at Mesa Community College have two (2) components. Both components must be completed to be considered valid for athletic eligibility.
 
Part 1
  • Physical
  • Health History Questionnaire
  • HIPPA Release
  • Assumption of Risk Acknowledgement Form

Part 2

  • ImPACT Baseline Concussion Test (see Concussion Policy)

 

 

If you have any questions, please call the MCC athletic training staff at: 480-461-7557

 

Kara Cummins, MEd, ATC, LAT


 

*** Important ***

 

This entire Pre-Participation Packet must remain intact and be turned in at the same time to be considered complete for eligibility purposes (This includes the ImPACT Baseline Concussion Test). A partially completed packet will not be accepted. Do not return this packets to your coaches, they must be delivered by the athlete to the athletic training staff. 

Ċ
Athletic Trainer,
Aug 14, 2014, 10:15 AM
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