Student-athlete
Information and Forms

Student-athletes are required to have a physical examination (By Our Team Physicians) prior to participation in any intercollegiate sports. Student-athletes and/or parents or guardians are not responsible for the cost of the physical examination. The team physician makes the final decision concerning an athlete’s initial physical qualifications to participate. If an athlete is qualified to participate and becomes injured while participating, the athletic trainer and/or the team physician will determine when an athlete may return to play. Mercyhurst North East is not responsible for any previously existing conditions. Dates and times of physical examinations will be provided to your Head Coach.

Download Insurance Information Form
Students participating in sports at Mercyhurst North East must give evidence that they have their own insurance since the Mercyhurst College policy is excess coverage only. Coverage for sports injuries through the College is on an excess basis. This means that the coverage provided is not the primary source of coverage. After your own insurance has paid their portion, you should forward copies of their explanation of benefits to the school for submission of the balance to the sports policy. The policy contains the following deductible: ALL SPORTS - $2000. No preexisting injuries are covered in this policy. Any payments made by your primary insurance carrier will be applied towards this deductible.

The downloadable insurance form that MUST be filled out and signed by both the student-athlete and parent/guardian and returned to the athletic department before the student-athlete participates in any practice or game. At the bottom of the insurance form, one of the three options must be checked. In the situation that a student-athlete does not have medical insurance coverage, they have basically two options. They could check “option B” and apply for medical coverage through First Agency insurance. This policy includes a one time non-refundable premium that will cover any non-preexisting athletic related injuries. For more information on this option, please contact the Sports Medicine department at (814) 725-6111. The second option is to check “option C” which basically states that the student-athlete does not have or has limited or inadequate insurance and does not want to purchase into the First Agency policy and is responsible for medical bills incurred up to $2000 before the master policy will take affect. If you have any questions regarding the insurance information, please contact Julia Slepko, Head Athletic Trainer, (814) 725-6111.

Download the Athletic Department Drug Policy
Click above for a copy of the MNE athletic department drug policy. Student-athletes and parent/guardians must read the policy and sign and date both the “Student-athlete consent form” and “Student-athlete rights and responsibilities form” and return them to the athletic department before competing in intercollegiate athletics at Mercyhurst North East.

Download the Health Information Release Authorization Form
This release form allows the athletic training staff to share pertinent health information with parents/guardians, spouses, coaching staffs, media outlets, scouts, insurance companies, other colleges or universities when appropriate. Student-athletes must read, sign and date the information release form before participation. The insurance forms, drug consent and responsibility forms, and health information release can be returned via fax at (814) 725-6128 or mailed to: Julia Slepko, Head Athletic Trainer, Mercyhurst North East, North East, PA 16428. Any questions, please call (814) 725-6111.