Intercollegiate Athletics Pre-Participation Forms

There are 4 forms required in order to participate in intercollegiate-athletics at Franciscan University.

All Forms are Due No Later Than August 1, 2011

Step 1:
Download and print all 4 forms. (Adobe Acrobat required)

1. Physical Exam Form 2011-12
2. Medical History Evaluation Form 2011-12
3. Certification of Insurance & Liability 2011-12
4. Athlete Consent and HIPAA Release Form 2011-12

Step 2:
The Physical Exam Form must be completed by a physician.
The other three forms (Medical History Evaluation, Certification of Insurance & Liability, Athlete Consent and HIPAA Release) must be filled out by the student-athlete (and parent(s) if applicable).

Step 3:
Mail or fax all forms

Franciscan University of Steubenville
Athletic Department ATTN: Kelly Gaughan
1235 University Blvd.
Steubenville OH. 43952
Fax: (740) 283-6437