Athletic Medical Forms

The athletic training department would like to take this opportunity to welcome you to Alfred State athletics. We hope your experience here is injury free, competitive, and fun-filled. Below you will find some links to forms that you must print out and fill out in entirety. The information is essential part of being involved at Alfred State athletics prior to participation. These forms are needed for both the NJCAA and the Alfred State athletic department. If these forms are not filled out completely you will not be allowed to try out or participate in Pioneer athletics.

Please note that all new student-athletes/transfers at Alfred State must have a completed/up to date (within the past year) physical before being allowed to participate in any intercollegiate sport. All returning student-athletes are required to complete an annual sports exam form prior to the start of their season. All student-athletes are required to have current insurance information and insurance card on file with the Athletic Training Staff.

Medical Form Checklist of Items Needed:

Please print and mail completed forms to:

Alfred State
Attn: Jason Smeenk, MS, ATC
10 Upper College Drive
Alfred, NY 14802

Please print and mail completed forms to:

Alfred State
Attn: Health Center
10 Upper College Drive
Alfred, NY 14802

Please place your home address on the forms. If you are under eighteen, this form should be also signed by a parent or guardian. The physical exam form should be filled out by your physician. The exam should be dated within the past year, and must clearly state that you may participate in intercollegiate athletics with no limitations. If limitations are involved a written statement by the primary care provider is required prior to your participation.

The medical information obtain is confidential and will be used to facilitate the best health care possible while you attend Alfred State.