Dear Lindenwood University - Belleville Student-Athlete:

The LU - Belleville Athletic Training staff would like to welcome you to our athletic program; we are glad you have chosen to be a part of Lindenwood University - Belleville. In preparation for the upcoming season we need your assistance to help start your sports medicine file. Enclosed you will find:

1. LU – Belleville PHYSICAL and MEDICAL HISTORY FORMS. PLEASE READ THE INSTRUCTIONS ON ALL PARTS OF THIS FORM. This form will take some time to fill out – please do so as COMPLETELY and ACCURATELY as possible. It is also very important that you familiarize yourself with the information on this form. While you may need parents help to complete portions of the form, such as the family medical history,please be sure you know the information that is on the form. Many of the questions ask for detailed explanations, the more information we have the better. Please do not forget to sign the last page of the medical history and your PARENT(S)/LEGAL GUARDIAN(S) MUST also sign the last page, unless you are married or over 18 years of age.

2. SICKLE CELL AWARENESS FORM. Athlete is required to provide us with verification of sickle cell status ordecline the sickle cell trait testing and sign the waiver. A helpful document for you to view is the LU-B Sickle CellInformation and Requirements document. These can be found under forms once signed into SWOL123.netReturning Student-Athletes do not need to repeat this step!!

3. SWOL INTRODUCTION TO ATHLETES LETTER. This is also used while traveling with your sport and in theevent of an emergency medical referral or a scheduled doctor’s appointment related to an athletic injury.THIS IS VERY IMPORTANT and REQUIRES ALL PORTIONS OF THE FORM TO BE COMPLETED.

4. Lindenwood University – Belleville ATHLETIC INSURANCE POLICY and ACKNOWLEDGEMENT OF INSURANCE. Proof of Primary insurance is required prior to participation. The primary policy holder must sign this document.

5. INSURANCE and EMERGENCY CONTACT INFORMATION. This is the form that is used while traveling with your sport and in the event of an emergency medical referral or a scheduled doctor’s appointment related to an athletic injury. THIS FORM IS VERY IMPORTANT and REQUIRES ALL PORTIONS OF THE FORM TO BE COMPLETED.This information is found under “my info” once signed into SWOL123.net

6. STUDENT - ATHLETE CONCUSSION FACT SHEET and STUDENT- ATHELETE CONCUSSIONSTATEMENT. These can be found under forms once signed into SWOL123.net

7. THIRD PARTY RELEASE. Please sign for consent allowed or declined for each section. This is found in swol123.net

We cannot emphasize enough our need for these forms to be as complete as possible. The completion of these forms will allow the process of physicals to be smoother and get you participating with your team on time. You should complete all required information prior to arriving on campus. This does not pertain to the physical if you will receive one after arriving to campus. We will need a copy of the front and back of your current insurance card. You can mail it to the LU-Belleville Athletic Training Department, email to sslone@lindenwood.edu, or bring it in when you report. Failure to fully complete the forms or submitting a current health insurance card will result in a delay in your ability to practice, compete, or participate in your sport.

If you have any questions regarding the information requested please do not hesitate to contact the athletic training staff at: sslone@lindenwood.edu or swilkerson@lindenwood.edu or wnetzhammer@lindenwood.edu or tvaldez@lindenwood.edu

If you have suffered a recent significant injury, or have a history of a medical problem/injury which will need to be looked at by our staff or team physician (ex. ACL reconstruction, recurrent shoulder dislocations, multiple concussions) please let us know immediately. This provides us time to request medical records, talk with your physician(s), etc. before you arrive for your pre-participation physical. Thank you for your cooperation and we look forward to meeting you this fall. Have a great summer!!

Sincerely,

Stephen Slone, MS, ATC Head Athletic Trainer

2016-2017

Dear Student-Athlete:

Prior to participating on a team from Lindenwood University-Belleville, athletes must provide the Athletic Training Department with current address, emergency contact, insurance, medical alert and health history information. To expedite this process we use an online data entry system. These forms will take some time to fill out – please do so as COMPLETELY and ACCURATELY as possible. It is also very important that you familiarize yourself with the information on this form. You may need parents help to complete portions of these forms.

To enter your information, visit www.swol123.net. The first time you visit the website you will need to follow the directions below. The School ID is LUBLYNX

IF YOU ARE A RETURING ATHLETE YOU SHOULD GO TO THE SAME WEBSITE AS ABOVE. ENTER YOUR EMAIL ADDRESS AND PASSWORD. IF YOU CAN’T REMEMBER YOUR PASSWORD CLICK ON THE RESET PASSWORD BUTTON. ONCE SIGNED IN, UPDATE ALL INFORMATION ESPECIALLY YOUR INSURANCE INFORMATION AND EMERGENCY CONTACT.

Joining SportsWareOnLine Instruction Example

Go to www.swol123.net. Scroll to the middle of the screen and click the Join SportsWare button. Enter your School ID

You should have received a School ID from the athletic trainer. This is required to join the correct school.

Enter your First Name, Last Name, Email address and click the Send button.

Your request to join SportsWare will then be sent to the Athletic Trainer for review.

Once your request is accepted you will receive an e-mail with the Subject “SportsWare request accepted”.

Open the e-mail and click the www.swol123.net link to continue to SportsWareOnLine .

Setting Your Password – RETURNING STUDENTS START HERE Instruction Example

Go to www.swol123.net

Enter your Email Address and click the Reset Password button. You will receive and e-mail with the Subject “SportsWareOnLine Password Request”.

Open the e-mail and click on the link to reset your password. Enter your e-mail address, new password and click the Save button.

Updating Your Information Instruction Example

Go to www.swol123.net

Enter your Email Address and click the Login button. At the top of the page is the Menu Bar.

My Info: Update your address, emergency contact and insurance

Thank you for your prompt help. If you have any questions, please contact the athletic training office at 618-239-6109 or by email sslone@lindenwood.edu for assistance.

Sincerely,

Stephen Slone, MS, ATC, Head Athletic Trainer Lindenwood University – Belleville 2600 W. Main St. Belleville, IL 62226

information.

Med History: Complete a Medical History questionnaire. Forms: View/complete required paperwork. Note: SportsWare will also display “You have ? forms to complete/download”.

Print: Print My Info and Medical History data.

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MEDICAL HISTORY QUESTIONAIRE Medical and Injury Information

Instructions: Be as thorough as possible in answering each question. If reply is yes, please explain.

General

Yes No Do you regularly take any medications? If yes, list:

Yes No Do you have allergies to medications, insect bites/bees, or environmental (ex. hay fever) If yes, explain:

Yes No Do you have any significant medical illness or problems? If yes, explain:

Yes No Have you had any surgeries? If yes, explain:

Yes No Have you ever been told you had diabetes? If yes, do you use insulin, pills, or diet to control your sugar?

Yes No Any immediate family member (dad, mom, brother, sister) with a history of diabetes? If yes, explain

Yes No Have you ever “passed out” or experienced dizziness with exercise? If yes, explain:

Yes No Have you ever had a seizure or been told you have epilepsy? If yes, explain:

Yes No Do you have any bleeding problems or hemophilia?

Yes No Do you have a history of abnormal menstrual cycles or bleeding?

Yes No Have you had a tetanus shot within: 5 years 10 years Unknown

Yes No Have you ever been told you had a hernia or had one surgically repaired?

Yes No Have you ever been told you have sickle cell trait or sickle cell anemia?

Head and Neck

Yes No Have you ever had a concussion, loss of consciousness, or been “knocked out”? If yes, explain:

How many times? Last episode: Were you hospitalized?

Yes No Have you ever had a burner, stinger, or numbness? If yes, explain:

How many times? Last episode: Were you hospitalized?

Yes No Have you received any medical care for any additional head or neck injuries? If yes, explain:

Eyes and Dental

Yes No Do you wear glasses? If yes, do you wear for athletic participation?

Yes No Do you wear contacts? If yes, do you wear for athletic participation?

Yes No Have you ever experienced blindness, blurred eyes, or double vision?

Yes No Have you ever been told your eyes have unequal pupils?

Yes No Do you have a history of chipped or lost teeth? If yes, explain:

Yes No Do you have bridges or other dental appliances? If yes, explain:

Yes No Do you have high blood pressure?

Yes No Do you have a heart murmur? If yes, explain:

Heart

Yes No Do you have an irregular heart beat or “palpitations”? If yes, explain:

Yes No Have you ever experienced chest pain with or without exercise? If yes, explain:

Yes No Any immediate family member (dad, mom, brother, sister) with a history of heart attack before the age of 55? If yes, explain:

Lungs

Yes No Do you have asthma?

Yes No Do you experience trouble breathing or wheezing? If yes to either of the above, explain:

Is it exercise related? Yes No Do you use an inhaler Yes No If so, what type:

Musculoskeletal

Yes No Are you prone to low back aches or strains? If yes, explain:

Yes No Have you ever received medical care for back problems? If yes, explain:

Yes No Are you prone to developing muscle cramps or strains? If yes, explain:

Yes No Have you ever had problems with a wrist or hand injuries? If yes, explain:

Yes No Have you ever had problems with a shoulder or elbow injuries? If yes, explain:

Yes No Have you ever had problems with hip injuries? If yes, explain:

Yes No Have you ever had problems with knee injuries? If yes, explain:

Yes No Have you ever experienced knee pain when competing?

Yes No Have you ever injured your knee ligaments or cartilage? If yes, explain:

Yes No Have you ever experienced stress fractures or shin splints?

Yes No Have you ever had problems with repeated ankle sprains? If yes, explain:

Yes No Have you ever had problems with your feet? If yes, explain:

Yes No Have you had any injuries that required surgery? If yes, explain:

Yes No Have you been treated for a fracture with the last 2 years? If yes, explain:

Yes No Any other medications, problems or concerns we should know about? If yes, explain:

Please Initial and Sign the following:

To the best of my knowledge, all the above questions have been answered completely and truthfully. I also give authorization to the athletic training staff and /or medical consultants to evaluate and treat any injuries that occur during my participation in athletics at Lindenwood University Belleville. I understand the athletic trainer has the authority to eliminate me from participation because of an injury and/or because of undue risk to Lindenwood University Belleville.

I also understand that I am responsible for reporting any injury or illness to Lindenwood University Belleville medical staff, including signs and symptoms of a concussion.

I grant the authorization for the release of medical and insurance information from the Lindenwood University Belleville athletic training/health service staff and any medical care provider, medical care facility, insurer, government-sponsored health plan, or employer to the university’s secondary insurance. This applies to all information necessary to determine the eligibility of any claim that I may ensue while at Lindenwood University Belleville due to any injuries that may have or may occur.

Athlete’s Signature Date

(If student is under 18yrs) Parent or Guardian’s Signature Date

Primary Insurance Requirements Participation in intercollegiate athletics involves the inherent risk of injury. For this reason, it

remains necessary for all student-athletes to maintain a personal health insurance policy throughout the school year in case of an athletic-related accident.

• Students will not be allowed to participate in any team activity or training until proof ofinsurance is provided to the athletic training department and the acknowledgement form iscompleted by the policy holder.

It is highly recommended the student-athlete’s health insurance policy has a reasonable deductible, as this will be the responsibility of the student-athlete and/or policy holder. Furthermore, this policy must meet the following criteria:

1) Coverage of interscholastic athletic-related accidents

2) Coverage in the state of Missouri or Illinois

3) Coverage for out-patient, in-patient, specialist, and emergency care in Missouri or Illinois

A. Coverage for ‘Emergencies Only’ in the state of Missouri or Illinois does not meet theuniversity’s mandatory insurance requirement

In addition to the specific criteria stated above: 1) Out-of-state Medicaid plans DO NOT meet Lindenwood University Athletics requirements.

2) If the student-athlete is covered by Kaiser Permanente or another HMO based outside of the St.Louis area, it is required to enroll in another policy that will provide benefits for athletic-relatedaccidents in the state of Missouri or Illinois.

• If an injury occurs and it is discovered the student-athlete’s primary insurance carrier does notprovide in-network benefits for providers in the area, the student-athlete may need to returnhome, at their own expense, for non-emergency medical care. In addition, if it is determinedthat a student-athlete incurred out-of-network expenses not covered by his/her primaryinsurance due to lack of coverage in the area, benefits from the secondary insurance policy maynot be available.

Secondary Insurance Information The university’s secondary insurance policy is limited to those injuries received, which in the

opinion of the team physician and certified athletic trainer, are directly attributable to participation in intercollegiate athletics while a full-time student at Lindenwood University.

The current secondary policy is an accident-only policy and an excess policy. *This policy carries a $1,000 deductible and eligible medical expenses payable under any otherinsurance policy or service contract may be used to satisfy or reduce the deductible. After the student athlete’s primary health insurance policy is exhausted and the $1,000 deductible has been met for the university policy, the secondary health insurance may provide up to the maximum benefit for eligible medical expenses. This may not include certain medical procedures, special services, durable medical equipment, etc.

In addition, this accident-only policy will not provide coverage for the following:

1) Costs incurred from the care of injuries and illnesses that are not linked directly to a specificathletic accident or event.

2) Costs associated with injuries and illnesses incurred while participating in activities notdirectly associated with the student-athletes intercollegiate program.

3) Costs incurred due to the treatment of pre-existing conditions.4) Costs incurred due to additional testing required as the result of issues or concerns raised

during the pre-participation examinations.5) Costs incurred from the emergency care of medical conditions that are not directly

attributable to the participation in intercollegiate athletics (ie. appendectomy).6) Costs incurred due to dental care not relating directly to an athletic incident.7) Costs incurred due to injuries associated with fighting (regardless of the setting).

Guidelines for Reporting an Injury/Submitting a Claim:

To ensure secondary coverage, the athlete must report all injuries and illnesses to the athletic training staff in a timely manner for appropriate evaluation and referral. All services must be coordinated and approved by the university’s sports medicine staff. Any costs related to medical services scheduled without notification and approval from the athletic training department will be the sole responsibility of the student-athlete. This does not include emergency care. In the event of an emergency visit, the student-athlete should seek assistance from the athletic training staff immediately after returning to campus.

Lindenwood University’s insurance coverage will not pay on the claim until they receive the billing statements from the medical providers and Explanation of Benefits (EOB’s) from your primary insurance company. The student-athlete must have all medical expenses filed with his/her primary insurance carrier first. Once the claim has been paid by the primary insurance carrier, the student- athlete must then submit the Explanation of Benefits from his/her insurance company to the university, along with a copy of the itemized bill for services rendered. Copies of these items will be sent to Lindenwood University’s secondary insurance company and final payments will be made upon approval.

It is the student-athlete’s responsibility to ensure the athletic training department has received all bills and EOB’s related to the injury.

At any time during this process, additional information may also be requested from the secondary insurance company regarding the primary insurance policy and parent employment. It will be the responsibility of the student-athlete to ensure all requested documents are submitted to the secondary insurance carrier in a timely manner. Any delinquent bills resulting in bad credit due to noncompliance with insurance company requests may be the responsibility of the student-athlete and/or his/her parent(s)/guardian(s).

*Failure to provide the athletic training department with the required paperwork will negate theuniversity's responsibility toward the incurred medical bills.

ACKNOWLEDGEMENT STATEMENT FOR PRIMARY AND SECONDARY INSURANCE

COVERAGE

I attest that (Print Name of Student-Athlete) has insurance coverage under a current insurance policy for injuries that occur during participation in intercollegiate athletics. This primary insurance policy is in compliance with all university requirements.

_I have been provided a copy of Lindenwood’s primary insurance requirements and guidelines for submitting a claim.

I understand the primary insurance requirements and confirm the provided proof of insurance meets the above criteria.

I understand the deductible for my primary insurance policy is my responsibility and the secondary policy will not provide benefits until the primary insurance has been fully exhausted and the $1,000 deductible for the secondary has been met.

I agree to notify the Lindenwood University Athletic Training Department if there is a material change in coverage or expiration of this policy within 30 days of the expected change.

I understand the secondary insurance inclusions, exclusions, and limitations. I understand all medical referrals for athletic injuries must be scheduled with prior

approval from the athletic training staff. I understand and agree that Lindenwood University assumes no responsibility

whatsoever for the payment of, or authorization to pay, medical expenses resulting from injuries that occur while participating in intercollegiate athletics at Lindenwood University.

Primary Insurance Policy Holder (Print Name) Date

Primary Insurance Policy Holder (Signature) Date

*This must be signed by the primary policy holder

*Accident medical expense insurance is required by each athlete prior to participation.

Primary Health Insurance Coverage

On an annual basis, all student-athletes will need to provide a copy of his/her current primary insurance card to the Athletic

Training Staff. Student-Athletes will NOT be allowed to participate in team activities which include games and/or practices until this requirement has been met. It is the student-athletes responsibility to notify the Athletic Training Staff immediately of changes to their health insurance coverage.

- Secondary Health Insurance Coverage

The university’s liability for medical expenses resulting from injuries and illnesses sustained by the student-athlete is defined as follows:

Liability is extended through a university secondary insurance plan to assist in covering costs and premiums for medical billings. This insurance policy is secondary and is utilized after the student-athlete’s personal primary insurance has been billed. Liability is further restricted to those injuries and illnesses received, which in the opinion of the Team Physician and

Certified Athletic Trainer, are directly attributable to participation in intercollegiate athletics while a full-time student at Lindenwood University - Belleville. The athlete must report all injuries and illnesses to the athletic training staff in a timely manner for appropriate evaluation and referral, and a claim must be filed within one year of the date of injury.

The secondary health insurance policy has a $1,000 deductible; eligible medical expenses payable under any other insurance policy or service contract will be used to satisfy or reduce the deductible.

After the $1,000 deductible has been met, the secondary health insurance policy assesses the case and may provide up to $25,000 worth of benefits per accident.

- Claim Filing Procedures

1. An Accident must be reported to the Athletic Training Room within a timely manner following the Accident.Accidents incurred during supervised practice or play should be reported to the Athletic Trainer or Athletic Department Official immediately following the injury.

2. All eligible charges submitted must be accompanied by an Explanation of Benefits (EOB) from the primaryinsurance carrier(s). The Claim Form must include information for BOTH parents if the student is less than 23 years of age or a spouse if they are married. Blank lines or N/A are not acceptable.

3. Incomplete Claim Forms will result in a processing delay. Allow up to 4-6 weeks for processing after all informationis received.

4. Please ensure that all bills are itemized, listing the patient’s name, date of service, diagnostic code, servicecode and the provider’s tax identification number. (HCFA 1500 and UB92 forms are preferable)

5. File only one Claim Form per loss (Accident). Once the initial Claim Form has been filed, additional informationsubmitted should be identified with the school’s name, the student’s name, ID# and the initial date of loss.

- Claim Forms

Please mail all claim forms to: (This will ensure that duplicate claims are not sent in as this will delay the claim process)

Attn: Stephen Slone, Head Athletic Trainer

Lindenwood University Belleville

2600 W. Main St., Belleville, IL 62226

What should i do if i think i have a concussion? Don’t hide it. Tell your athletic trainer and coach. Never ignore a blow to the head. Also, tell your athletic trainer and coach if one of your teammates might have a concussion. Sports have injury timeouts and player substitutions so that you can get checked out. Report it. Do not return to participation in a game, practice or other activity with symptoms. The sooner you get checked out, the sooner you may be able to return to play.

Get checked out. Your team physician, athletic trainer, or health care professional can tell you if you have had a concussion and when you are cleared to return to play. A concussion can affect your ability to perform everyday activities, your reaction time, balance, sleep and classroom performance.

Take time to recover. If you have had a concussion, your brain needs time to heal. While your brain is still healing, you are much more likely to have a repeat concussion. In rare cases, repeat concussions can cause permanent brain damage, and even death. Severe brain injury can change your whole life.

CONCUSSION A fAct sheet for student-Athletes

it’s better to miss one game than the Whole season. When in doubt, get checked out. For more information and resources, visit www.NCAA.org/health-safety and www.CDC.gov/Concussion.

Reference to any commercial entity or product or service on this page should not be construed as an endorsement by the Government of the company or its products or services.

What are the symptoms of a concussion? You can’t see a concussion, but you might notice some of the symptoms right away. Other symptoms can show up hours or days after the injury. Concussion symptoms include: • Amnesia. • Confusion. • Headache. • Loss of consciousness. • Balance problems or dizziness. • Double or fuzzy vision. • Sensitivity to light or noise. • Nausea (feeling that you might vomit).• Feeling sluggish, foggy or groggy.• Feeling unusually irritable. • Concentration or memory problems (forgetting game plays, facts,

meeting times). • Slowed reaction time.

Exercise or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games may cause concussion symptoms (such as headache or tiredness) to reappear or get worse.

What is a concussion? A concussion is a brain injury that: • Is caused by a blow to the head or body.

– From contact with another player, hitting a hard surface suchas the ground, ice or floor, or being hit by a piece of equipment such as a bat, lacrosse stick or field hockey ball.

• Can change the way your brain normally works. • Can range from mild to severe. • Presents itself differently for each athlete. • Can occur during practice or competition in ANY sport. • Can happen even if you do not lose consciousness.

hoW can i prevent a concussion? Basic steps you can take to protect yourself from concussion: • Do not initiate contact with your head or helmet. You can still get

a concussion if you are wearing a helmet. • Avoid striking an opponent in the head. Undercutting, flying

elbows, stepping on a head, checking an unprotected opponent, and sticks to the head all cause concussions.

• Follow your athletics department’s rules for safety and the rules of the sport.

• Practice good sportsmanship at all times. • Practice and perfect the skills of the sport.

For more information and resources, visit www.NCAA.org/health-safety

A FAct Sheet For Student-AthleteS

SICKLE CELL TRAIT What is sickle cell trait?

sickle cell trait is not adisease. Sickle cell trait is the inheritance of one gene for sickle hemoglobin and one for normal hemoglobin. Sickle cell trait will not turn into the disease. Sickle cell trait is a life-long condition that will not change over time.

u During intense exercise, red blood cells containing the sickle hemoglobin can change shape from round to quarter-moon, or “sickle.”

u Sickled red cells may accumulate in the bloodstream during intense exercise, blocking normal blood fl to the tissues and muscles.

u During intense exercise, athletes with sickle cell trait have experienced significant physical distress, collapsed and even died.

u Heat, dehydration, altitude and asthma can increase the risk for and worsen complications associated with sickle cell trait, even when exercise is not intense.

u Athletes with sickle cell trait should not be excluded from participation as precautions can be put into place.

Do you knoW if you have sickle cell trait?

People at high risk for having sickle cell trait are those whose ancestors come from Africa, South or Central America, India, Saudi Arabia and Caribbean and Mediterranean countries.

u Sickle cell trait occurs in about 8 percent of the U.S. African-American population, and between one in 2,000 to one in 10,000 in the Caucasian population.

u Most U.S. states test at birth, but most athletes with sickle cell trait don’t know they have it.

u The NCAA recommends that athletics departments confirm the sickle cell trait status in all student-athletes.

u Knowledge of sickle cell trait status can be a gateway to education and simple precautions that may prevent collapse among athletes with sickle cell trait, allowing you to thrive in your sport.

hoW can i Prevent a collaPse? u Know your sickle cell trait status. u Engage in a slow and gradual preseason

conditioning regimen. u Build up your intensity slowly while training. u Set your own pace. Use adequate rest and recovery

between repetitions, especially during “gassers” and intense station or “mat” drills.

u Avoid pushing with all-out exertion longer than two to three minutes without a rest interval or a breather.

u If you experience symptoms such as muscle pain, abnormal weakness, undue fatigue or breathlessness, stop the activity immediately and notify your athletic trainer and/or coach.

u Stay well hydrated at all times, especially in hot and humid conditions.

u Avoid using high-caffeine energy drinks or supplements, or other stimulants, as they may contribute to dehydration.

u Maintain proper asthma management. u Refrain from extreme exercise during acute illness,

if feeling ill, or while experiencing a fever.

u Beware when adjusting to a change in altitude, e.g., a rise in altitude of as little as 2,000 feet. Modify your training and request that supplemental oxygen be available to you.

u Seek prompt medical care when experiencing unusual physical distress.

SICKLE CELL INFORMATION AND REQUIREMENTS

DEFINITION “Sickle cell trait is an inherited condition of the oxygen carrying protein, hemoglobin, in red blood cells. This genetic trait is generally benign, but during maximal exercise, the oxygen levels in muscles can decrease sufficiently to cause some of the red cells to change from the normal disk shape to a crescent or sickle shape. These sickled red blood cells can block blood vessels in muscles, kidneys, and other organs and can pose a grave risk for some athletes exercising all---out.”1

1 Eichner, E.R Sickle Cell Trait and the Athlete. Gatorade Sports Science Institute (www.gssiweb.com). Sports Science Exchange #103. 19(4): 2006 NCAA. A Fact Sheet for Student---Athletes. Sickle Cell Trait.

WHAT HAPPENS WITH EXERCISE “Heat and dehydration increase sickling, mainly because they make the drill more difficult and drive the blood oxygen lower. Exercise---induced asthma and the thin air of altitude also increase sickling because of lower blood oxygen.”1

It becomes more important to know if you have sickle cell trait as an athlete. There have been an increase number of deaths throughout the United States in sports and more specifically in football. Recent heat related deaths in athletics have now been more specifically linked to having sickle cell. It does not necessarily happen following prolonged exercise but during short hard intense exercise that can occur at the beginning of practice or anytime throughout.

WHO IS AFFECTED About 1 in 12 African---Americans carry one sickle cell gene but usually do not have any symptoms. Sickle cell can affect other populations as well including Hispanic---American Caribbean, Mediterranean, Asian and Middle Eastern and even in the Caucasian population, but at a lower rate. Sickle cell has a higher incidence of occurring if both parents have the trait but can be passed down through only one parent.

RECOMMENDATIONS At this point there is no cure if you have the sickle cell trait. Athletes that have sickle cell trait should not be excluded from participation. Measures can be taken to help protect you in the event that you do, that may include exercise modification and increasing your hydration. More and more research is being done into sickle cell. For more information you can go to the Sickle Cell Disease Association of America’s website (www.sicklecelldisease.org).

Sickle Cell testing is being done at birth in most states, but most athletes with sickle cell trait do not know if they have it. Whether or not you have confirmed the existence of sickle cell trait it is important that you report the onset of symptoms which can include cramping, pain, weakness, fatigue and shortness of breath to the certified athletic trainer immediately.

Knowledge of sickle cell status can be a gateway to simple precautions. These precautions can include insuring that you hydrate before, during and after exercise; avoid high---caffeine energy drinks or supplements as they may contribute to dehydration; do not exercise if feeling ill or experiencing a fever;

acclimation to heat and good gradual base conditioning program before in season practices is important as well; building up your intensity slowly and setting your own pace with adequate rest time between intense repetitions; and avoid all---out exertion longer than two to three minutes without a rest interval or breather. More information can be found by watching the following video. http://s3.amazonaws.com/ncaa/web_video/health_and_safety/sickle_cell/sickleCell.html

REQUIREMENTS The NCAA and Lindenwood University---Belleville Athletics has recently adopted a requirement that all student---athletes who are playing a sport report knowledge of their sickle cell status or release the institution from liability if they decline testing. You must do one of following things before you are allowed to participate in any intercollegiate athletics event, including strength and conditioning sessions, practices, competitions, etc.

1. Show proof of a prior sickle cell test. If you were born after 1989 in the State of Illinois you canrequest your results by calling the Newborn Screening Follow---up Program at the Illinois Department of Public Health at 217---785---8101. If you were born outside of Illinois you should contact your birth state’s Department of Public Health and request the results. The following website will help you find that information. http://genes-r-us.uthscsa.edu/resources/consumer/statemap.htm

2. You may call your local physician and request the test.

3. You may decline to be tested and sign the waiver.

All test results or signed waiver must be returned to Lindenwood University---Belleville Athletic Training Department prior to any participation in intercollegiate athletics.

SICKLE CELL TRAIT TESTING AWARENESS FORM Lindenwood University-Belleville mandates that all student-athletes have knowledge of their

sickle cell trait status before participating in any intercollegiate athletics event including, but not limited to; strength and conditioning sessions, practices, and competitions. If you were born after 1989 in the State of Illinois you can request your results by calling the Newborn Screening Follow-up Program at the Illinois Department of Public Health at 217-785-8101. If you were born outside of Illinois you should contact your birth state’s Department of Public Health and request the results. Go to the following website to find your state lab, call and request your results through the Newborn Screening Follow-up Program. http://genes-r-us.uthscsa.edu/resources/consumer/statemap.htm

OR I do not wish to undergo sickle cell trait testing as part of my pre-participation physical

examination and I voluntarily agree to release, discharge, indemnify and hold harmless the State of Missouri, the University, its officers, employees and agents from any and all costs, liabilities, expenses, claims, demands, or causes of action on account of any loss or personal injury that might result from my non-compliance with the mandate of the Lindenwood University-Belleville Department of Intercollegiate Athletics.

Student-Athlete Print Name Date If under 18 years of age, a paper copy of this form must be signed by parent/guardian

I will provide the Lindenwood University-Belleville Athletic Training Department with proof denoting my sickle cell status. Additionally, I understand that I will be unable to participate in any University-sponsored practices or games until I provide proof of sickle cell status to the Lindenwood University-Belleville Athletic Training Department.

Student-Athlete Print Name Date

If under 18 years of age, a paper copy of this form must be signed by parent/guardian

Student athletes have the following options regarding sickle cell testing. Please initial and sign in the appropriate box below. Please choose only one of the following options: