Health Forms

Every student attending Rhodes College must submit the required medical information forms and provide proof of comparable health insurance (with coverage in the Memphis TN, area) before being permitted to enroll in classes. Rhodes College offers a student health insurance plan to ensure that all students have access to comprehensive health insurance in Memphis while attending the college. Additional information is available at First Student – Rhodes College.

Students planning to participate in varsity athletics (baseball, basketball, cross country, field hockey, football, golf, lacrosse, soccer, softball, swimming/diving, tennis, track, volleyball) require additional forms. Each form has a required time they must be submitted in relation to the student ‐ athlete arriving at Rhodes. This document exists to help clarify which required medical forms are needed by each group and when those forms must be completed by the student.

Rhodes College uses a Health Information System that shares relevant information between the Student Health Center and the Athletic Training Office to ensure quality medical care. Health Forms MUST be uploaded via Medicat Patient Portal and athletic forms may be emailed to atr-forms@rhodes.edu as PDF document. Submitting HEALTH forms by email, fax, or mail  is not allowed.

Please mail ATHLETICS ONLY paper forms to:

Rhodes College Athletic Training Office
ATTN: Andrew B. Gibson, III
Coordinator of Athletic Training Services
2000 N. Parkway
Memphis, TN 38112
(901) 843‐3465 - phone
atr-forms@rhodes.edu

 

ALL STUDENTS

Every incoming student must submit the following forms by June 1st:

  1. Medical History Form [paper – download and print form; complete, sign, and UPLOAD to Medicat Patient Portal]
  2. Health Insurance Information Form [paper ‐ photocopy the front and back of the student’s insurance card, tape those copies to the printed form, and UPLOAD to Medicat Patient Portal]
  3. Physical Examination and Immunization Record [paper – download and print the form, have a physician complete and sign it, and UPLOAD to Medicat Patient Portal]
    If you have any questions or concerns about the state of TN immunization requirements please click here.

IF YOU ARE NOT PLAYING ANY VARSITY SPORTS AT RHODES, YOU CAN STOP READING NOW AND DISREGARD THE REST OF THIS DOCUMENT.

ATHLETES ONLY

Every varsity athlete must submit the following forms by December 1st:

1. Join SportsWare OnLine

2. EKG (Please provide the original 12 lead EKG tracing printout. Email to atr- forms@rhodes.edu or fax to 901-257-0550). EKGs will be available at Athletics Physicals for $40.00 (This will be charged to Student Account).

3. Sickle Cell Confirmation (Make a copy of the documentation and mail to Rhodes College) All Rhodes College athletes must have documentation of sickle cell trait before the student athlete can practice, lift, or perform any team activities, by one of the following options:

  1. Documentation by state at birth (click here for information about how to contact state authorities)
  2. Sickle cell solubility blood test results
  3. Waiver—a student-athlete may sign a waiver in all sports except for football. If the student athlete chooses the waiver option, he/she must meet individually with and get approval from the head athletic trainer to obtain a waiver. Excuses of convenience will not be approved.
  4. Sickle Cell solubility blood tests will be available at Athletics Physicals for $20.00 (This will be charged to Student Account).

4. Impact Baseline Concussion Testing

  1. https://www.impacttestonline.com/testing/
  2. Customer Code = 029D342CC7

5. Please review Insurance Claim Procedure

6. Medical Exception paperwork, if applies:

  1. Exceptions may be granted for substances in the following classes of banned drugs: stimulants, beta blockers, beta-2 agonists (albuterol inhalers), diuretics, anti- estrogens, anabolic agents (steroids), and peptide hormones
  2. If you have concerns about your prescribed medications that may be banned, please go to www.drugfreesport.com/rec (User name/password: NCAA Division III/ncaa3)

7. ADD/ADHD paperwork, if applies (Request necessary forms via e-mail to: atr- forms@rhodes.edu)

  1. ADD/ADHD Form
  2. ADD/ADHD Rating Scale Report and Summary
  3. Summary of comprehensive clinical evaluation
  4. Blood Pressure and Pulse Ratings and Comments
  5. Note that alternative non-banned medications have been considered
  6. Diagnosis
  7. Copy of prescription of the medication(s) and Dosage
  8. Follow-Up Orders

If the proper documentation for medical exceptions is not on file and the student-athlete fails a drug test, the athletic training staff will not be able to appeal for a medical exception. The resulting penalty for the student-athlete may include a suspension of 365 days from the date of the positive drug test. If proper documentation is on file, we will be able to submit the medical exception to the NCAA without any penalties. If you have any questions regarding medical exceptions, please contact Andrew Gibson. For any other questions, please contact Andrew Gibson.