University of Minnesota Athletics
Letter to Incoming Student Athletes
5/6/2011 12:00:00 AM | Athletics
May 18, 2011
Dear Incoming/Transfer Student-Athletes and Parents,
Welcome to the University of Minnesota! The Athletic Medicine Unit is committed to providing our student-athletes with the best possible medical coverage. On our website, you will find information about the University’s insurance requirements, how to manage medical bills and general information about medical services.
These are important forms to be printed and completed (clicking on the name of the form will take you to the form):
- Demographics/Insurance Information form
*Please include copies of the insurance cards for health, dental and pharmacy (front and back). - Incoming Health History Questionnaire
- General Consent Form
- E-Mail Consent Form
- U of M Athletics Authorization to Use or Disclose Health Information
- Medical Management Agreement and Assumption of Risk
- Alcohol and Drug Education & Drug Testing Program Consent Form
- Health Services to Minors-Authorization for Treatment of Minors Form
(Only if the student-athlete is under the age of 18)
After completion, these forms need to be sent to us for processing on or before July 1, 2011
Mail completed forms to:
Deb Canfield
Bierman Athletic Medicine
516-15th Ave. SE, Room 190
Minneapolis, MN 55455
Any student-athlete who wishes to practice or compete must provide proof of health insurance prior to the first day of practice. Also note that all new student-athletes must have a pre-participation exam prior to practice or competition. Please contact your sport specific Certified Athletic Trainer to arrange a pre-participation physical exam.
In the event of an athletic related injury, all medical bills will be paid through a coordination of benefits with the student-athlete’s private insurance acting as primary coverage. The University of Minnesota is only responsible for the balance on athletically-related injuries. We will manage and facilitate medical care for some non-athletic related issues, but we do not financially cover pre-existing or non-athletic related injuries or conditions. For example, medications or office visits for any pre-existing condition (i.e. asthma, eating disorders, etc.) are not covered by the University of Minnesota. We will not be liable for these services. In these cases, the parents/guardians will be responsible for the balance once the primary insurance has paid.
We encourage you to discuss your insurance policy's coverage with your son/daughter prior to the start of the year and provide them with an updated insurance card to carry with them at all times. In December, an e-mail will be sent to your child asking if there have been any changes in their insurance. We will ask them to forward the e-mail to you. Please respond to this e-mail only if there has been or will be a change in your insurance/policy coverage.
Please read through the information provided and feel free to contact either of us if you have questions or desire clarification on any of the forms. We wish you a happy, healthy and successful year!
Sincerely,
| Moira Novak, MS ATCDirector of Athletic MedicineUniversity of MinnesotaOffice #: (612) 624-5084E-mail: doyle042@umn.eduFax#: (612) 626-4789 | | | Deb Canfield Insurance Coordinator / Bierman Clinic Administrator University of Minnesota Office #: (612) 626-2066 E-mail: canfi064@umn.edu Fax#: (612) 626-4789 |
