You can download any form by clicking on the respective
links. You will need a version of Adobe Acrobat Reader.
To download the latest version
click below :

Please Check To See If Any
or All Of These Eight Categories Apply, And Please
Read Completely and Thoroughly:
Christian Brothers University
Directions for student athletes to complete their medical
records:
1) All Student-athletes:
All student-athletes must complete the following forms
annually as required by our secondary insurance carrier:
a) Insurance
Data form
b) Provide a copy of the Insurance Card from your primary
insurance:
(FRONT AND BACK OF CARD REQUIRED)
c) Read
and sign the CBU waivers and releases form:
d) Acknowledgement of Insurance Form (Domestic
Students) (International
Students)
2) Returning Student-athletes:
All returning Student-athletes must complete the insurance
forms ANNUALLY (see: All Student-athletes)
a) In addition to insurance, please complete the Follow-up
Medical Questionnaire, which is a pink form.
3) New Student-athletes: (to CBU)
All incoming student athletes are required to provide
a sport's physical and insurance information
(see: All Student-athletes) prior to any activity in
their chosen sport.
a) Complete
the CBU medical history form.
b) Provide a copy of the blue health
services physical form that came in your CBU application
package.
This is a sport's physical that is generally good for
4 years. Please send a copy prior to mailing your application,
if possible. Health Services does not open until the
first day of school. Marian Baker, the Health Services
Director,
can be reached at (901) 321-3260.
c) Transfer students may be required to provide an adequate
sport's physical at your own expense.
Please see the Athletic Trainer.
4) All International or Multinational Student-athletes:
All international student-athletes are subject to
immigration and naturalization requirements.
a) Your primary insurance must have evacuation and
repatriation benefits and is subject to review
by
Karen Conway (901) 321-3536.
b) If you do not provide proof of adequate coverage,
CBU will purchase insurance for you that will be
charged to your account in the business office.
c) Please visit Ms. Conway in student life upon your
arrival to campus to complete the paperwork and
determine
if you need primary insurance through the school.
5) 5-year athletes:
Fifth-year seniors (red-shirts and medical hardship
waivers) that spend their entire career at CBU may
be required to obtain a physical prior to the start
of their fifth year. Please see the Athletic Trainer
to
determine if this applies to you.
6) Review
the Athletic Director's memo to parents, this document
contains important information!
Please see the Athletic Trainer or call (901)
321-3263 with questions, problems, or feedback.
7) Student-Athlete's
Bill of Rights
8) Student-Athlete
Tryout Form (This must be filled out and signed
by a parent/guardian prior to the tryout)
Completed forms may be mailed to:
Christian Brothers
University Athletics
650 East Parkway
Box T-1
Memphis, Tennessee 38104
faxed to: (901)
321-3570 or handed to the athletic trainer upon
your arrival.
|