Sports Medicine Department
Welcome from Baker University Sports Medicine
Baker Student-Athletes and Parents,
Please take a minute to review the following important materials. All information must be completed thoroughly and returned to the Sports Medicine Department before you are allowed to participate in any athletically related practices or competitions. When completed, mail or fax all documents (Physical Examination and Medical History, Insurance Questionnaire, Acceptance of Risk/Liability Waiver, and Personal Data) to the attention of the Sports Medicine Department by August 1, 2013. In the event that the documents are not received by this date, you will not be eligible to participate in practice and will be assessed a $20 late processing fee on your student account. Please call with any additional questions.
You must return all of the following by August 1, 2013:
Physical Examination and Medical History
This must be completed yearly and must be administered and signed by one of the following: Doctor of Medicine (MD), Doctor of Osteopathy (DO), Physician Assistant (PA) or Nurse Practitioner (APRN). Physical examinations signed by a health provider other than requested will NOT be accepted and a subsequent examination will be required by an appropriate provider.
Insurance Questionnaire
This requests a legible copy of your medical insurance card be copied, front and back, cut, and taped in the designated spaces. Please complete in full and to the best of your knowledge. Please secure a card for your personal use. Providers require this upon admittance for services.
Acceptance of Risk/Liability Waiver
Please read thoroughly, sign and date.
Personal Data
This form contains your contact information for the academic year. If some information is unknown, complete as best you can, send it and we will complete it during health screens.
Please download the following:
- Physical Examination/Medical History and Insurance Questionnaire
- Personal Data and Acceptance of Risk/Liability Waiver
Once completed, fax all four forms (five pages) to 785-594-8465 or mail all forms to Baker University Sports Medicine, 618 8th Street, Baldwin City, KS 66006
Please review the document below. Baker University secures an excess or secondary athletic accident insurance policy and this is briefly outlined below.
Download information about excess insurance information for parents by clicking here
Drug Testing Policy
Please become familiar with our Baker University Athletics drug testing policy by clicking here.
Sports Medicine Department Staff
Lynn Bott, MS, ATC, LAT
Director of Sports Medicine, Assistant Professor
(P) 785.594.8424 (F) 785.594.8465 (C) 785.979.4882
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Lynsey Payne, MS, ATC, LAT
Athletic Trainer, Assistant Professor
(P) 785.594.8499 (F) 785.594.8465 (C) 785.979.4883
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