Welcome to Los Angeles Mission College Athletics
Dear Student Athlete:
Congratulations on your decision to participate in athletics at Los Angeles Mission College. Before you can participate in your particular sport, you must be a registered student at Los Angeles Mission College, complete all the necessary paperwork and be cleared by a physician.
Before beginning this process, please have the following available:
1. Your student ID number which begins with the numbers 88-
2. Your address and phone numbers (home and cell, if you have a cell)
3. Your MEDICAL and DENTAL insurance card with policy and group numbers (if you have insurance)
4. Your parent's information, including their address and phone numbers (home and cell, if they have a cell), and their work information (including address and phone number).
5. An emergency contact person (including address and phone number).
Instructions for Filling out the Medical Packet
As the Athletic Trainer of Los Angeles Mission College, I would like to welcome you to the Los Angeles Mission College athletics program. Prior to your participation in any sports activity all student-athletes are required to have on file a MEDICAL PACKET that will be kept in the athletic training room with me. To assist you in filling out the medical packet, please follow the directions below. If you have any questions, please contact me at (818) 364-7600 x4567.
Please
PRINT on all forms, except where a signature is required, with
blue or black ink.
1. Log on to the Los Angeles Mission College Health and Fitness Education website: http://www.lamission.edu/fitness/
2. Under "Meet the Staff" locate and click on my name “ Tresha San Martin”
3. Under “My Pages” on the left hand side click onto “LAMC Medical Packet”. Six (6) pdf files and four (4) doc files should be displayed. This is your medical packet.
4. Print out one (1) copy of all the forms listed below with the exception of the Emergency Information_Mission 2007 form. You will need to print out two (2) Emergency Information forms.
Each form MUST be filled out COMPLETELY. This includes yours and your parents information, all medical insurance information, and signatures where required. Do not leave any blank lines empty. Doing so may delay your “CLEARANCE TO PLAY”. If a question does not apply to you mark “N/A” on the space provided. If you are under 18 please have your parent sign these forms.
Emergency Information_Mission 2007.pdf (print out 2 copies)
Verification of Other Insurance Form_2007.pdf
Preparticipation Physical Evaluation Card_2011.pdf
Multi Form_Mission_2007.pdf
Mission_StudentWaiver_2007.pdf
Medical Information Authorization Release Form_Mission_2009.pdf
Orientation Agreement.doc
Student Athlete CONCUSSION Fact Sheet.doc
LAMC Injury Reporting Acknowledgement form.doc
Standard Assessment of Concussion.doc
5. Bring your completed medical packet (all 14 pages in the order shown above) with you on the day of your pre-participation exam (aka physical). You will not be able to have your physical performed without this packet. All athletes are required to wear T-shirt and shorts for these exams.
NEXT
1. Under “My Pages” on the left hand side click onto “Orientation Packet”. One doc
file should be displayed. Read this section thoroughly and print out the Orientation
Agreement.
2. Fill out the
Orientation Agreement and return it to your Athletic Trainer.
Thank you for your cooperation and Good Luck!
