This is a multi-purpose form that informs the student-athlete of the inherent risk associated with participating in any athletic activities within the intercollegiate athletic department at an NCAA member institution. The subsequent sections allow the sports medicine staff to evaluate and treat any injury that might occur during an intercollegiate activity as well as allowing the sports medicine department to disclose information about those injuries to the individuals listed on the form and only those people. This form also includes an NCAA HIPAA form that allows the NCAA member institution to keep medical file on a secure server at the NCAA Headquarters as well as allows the NCAA to perform random drug testing to any student-athlete.
General Authorization For Release Of Information
State:
Multi-State
Control #:
US-01717BG
Format:
Word;
Rich Text
Instant download
Description Form Medical Release
Free preview Hipaa Release Form
How to fill out Form Hipaa Pdf?
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