ATHLETICS PRE-PARTICIPATION PHYSICAL FORM

The mission of CCSF Sports Medicine is to promote health and safety in sport while maintaining an environment focused on positively impacting the lives of every student-athlete and encouraging possibilities beyond CCSF.

The sports medicine team is lead by board certified athletic trainers, Emerald Molina and Sara Golec. While we work closely with several physicians in order to provide the best care possible, our two head team physicians are Dr. Sara Edwards of UCSF (Orthopedic Surgery) and Dr. Ryan Cudahy of Dignity Health (Primary Care – Sports Medicine). In addition, our team physical therapist, Dr. Greg Ohanessian, is often on campus to work with post-operative and complex medical cases. Due to the hard work of these special individuals, CCSF is able to serve the healthcare needs of the student-athletes promptly and precisely to allow them the opportunity to achieve success in athletics and life.

Instructions to Become Medically Eligible:

CCSF Sports Medicine utilizes the Healthy Roster app for medical record keeping. ALL student-athletes must have an account. Request a healthy roster invitation here: https://forms.gle/aKsddSSPZcUUZmeG7

Please allow 24 hours for the invitation to be sent. The invitation contains a code specific to each individual as well as the link to download the app on your phone or tablet. Here is a brief video with instructions on how to create an account: Parent/Athlete Walkthrough - Healthy Roster Customer Support (helpdocs.io)

Once a student-athlete is on the healthy roster platform, the following documents must be submitted and approved:

Assumption of Risk
Consent to Treat
Insurance and Emergency Contact Information
Medical History Questionnaire
Pre-Participation Physical Examination

Pre-Participation Physical Examination:

CCSF hosts physical examinations once every semester. To sign up for the next physical exam, please click here: https://calendly.com/d/dh9-js8-c4t

If a student-athlete decides to go to their personal physician, they should print the following form and bring it to their appointment to be completed by the MD or DO (CCCAA requirement). Meaning any physicals completed by an individual that is not a medical doctor or doctor of osteopathy will NOT be approved. Please upload your completed physical form to your healthy roster account.

ATHLETICS PRE-PARTICIPATION PHYSICAL FORM