Explanation of Medical Insurance Forms
In order to participate, tryout or workout for any Athletic Team at Queensborough Community College, two (2) separate forms must be completed and validated with an official stamp.
Form # 1: Pre-participation Physical Evaluation Form (Medical Form)
- Each Athlete must complete entire form.
- All health concerns must be listed and addressed.
- Any Yes answer must be explained (where indicated).
- The Athlete must be examined and “Cleared to Play” by a Medical Doctor.
- Once the athlete is “Cleared to Play”, the Medical Office will validate the form with an Official Stamp.
- Athletes can make arrangements to have Medical Exams with a doctor of their choice.
- The Athletic Department will supply dates (TBA) to have a Medical Doctor complete Medical Exams free of charge @ QCC.
- Medical Exams are valid for 356 days (1 year).
Form # 2: Insurance Information Form - contact the Atheltic Director for a copy of the form
- Each Athlete must complete entire form and print two copies.
- Each Athlete must take completed Insurance Form (both copies) with their Health Insurance Card to QCC Health Services (MC-02).
- If an Athlete does not have Health Insurance, speak with the QCC Athletic Director for possible solutions.
- Once the Athlete is “Cleared to Play”, QCC Health Services will validate the form with an Official Stamp.
- Insurance Forms are valid from July-May of each year.
Both validated (stamped forms) should be given to Jon Hochberg, Athletic Director and / or Head Coach. For additional information about eligibility requirements, please contact Jon Hochberg, Athletic Director or the Head Coach.