Returning Student-Athlete

Welcome back Falcons!

Your understanding of the policies and procedures related to health care, privacy, and health insurance is critical to your success as a student-athlete.  Please carefully read all of the information that follows before completing and submitting the forms.

All forms must be completed in their entirety, and all requested documentation must be submitted before you will be permitted to participate in any sport-related activity at Daytona State.  Please type your responses directly on the forms, then choose one of the following options: 

1. email to burnst@daytonastate.edu or

2. Print and mail to:

Trevor Burns
Daytona State College
Athletic Department Bldg. 310
1200 W. International Speedway Blvd.
Daytona Beach, FL  32114

The deadline to return all forms is August 1, 2013
Faxed forms will NOT be accepted
(Scanned & e-mailed forms will be accepted)

**All forms must be completed even if the information has not changed since last year**

The following items are for you to read and keep for reference:

Procedures Regarding Athletic Injuries, Illness & Medical Care

Notice of Privacy Practices

Supplement Use & Daytona State College's Drug and Alcohol Policy

Please type your responses directly on the forms, then sign and return to the above address:

Daytona State College Follow-Up Medical Questionnaire

Student-Athlete Insurance Information

Health Insurance Information Signature Page

Protected Health Information Consent