ATHLETIC TRAINING INFORMATION AND

PROCEDURES

Jaime Dickerson, MA, ATC

Athletic Trainer

973-661-8995

jdickerson@nutleyschools.org

PHYSICAL INSTRUCTIONS ALL FORMS MUST BE TURNED IN TOGETHER!! All incoming freshmen need a sports physical. This is not the

same as the school physical which is turned into the nurse. Athletes cannot practice until ALL forms are turned in. Physicals must be signed off by school doctor before sports

participation, therefore, forms MUST be turned in one week before practices start. All forms are due by February 14, 2013

Sports physicals are good for one calendar year. If a physical has been turned in for a previous sport an

“Update” must be done.

UPDATED PHYSICAL “Update” means you have turned in a physical for a

previous sport. Update includes the following forms.

Health History Questionnaire NHS Random Drug and Alcohol Testing Nutley Media Release Form NJSIAA Random Steroid Testing NJSIAA Concussion Policy Emergency Card Athletic Parent Code of Conduct

FORMS Physical Evaluation Form Health History Questionnaire Emergency Form NHS Random Drug and Alcohol Testing Nutley Media Release Form NJSIAA Random Steroid Testing NJSIAA Concussion Policy Athletic Parent Code of Conduct

PHYSICAL EVALUATION FORM•Form gets filled out by physician•If athlete sees a separate eye doctor please have this section filled out by that physician.•This is the ONLY form that will be accepted from the physician.

HEALTH HISTORY QUESTIONNAIRE•Make sure the last page is signed by a parent/guardian. •Explain ALL “YES” answers•Any fall athlete that has turned in a physical, this form needs to be filled out instead of the physical.

EMERGENCY FORM•Fill out entire form. •Make sure to include any medical issues or allergies that athlete has.•Make sure bottom of the form is signed.

NHS RANDOM DRUG AND ALCOHOL TESTING•Fill out entire form.•Specify what sport on the line provided.•Make sure both parent/guardian and athlete sign form.

MEDIA RELEASE FORM

•Be sure to check off whether permission is given or not given.•Fill out form and make sure it is signed.

NJSIAA RANDOM STEROID TESTING

•Make sure form is signed by the parent/guardian and the athlete.•Specify what sport they are playing on the top right hand corner.

NJSIAA CONCUSSION POLICY•Form is TWO pages•Make sure to read both sides•Make sure parent/guardian and athlete sign form.

ATHLETIC PARENT CODE OF CONDUCT• Form is TWO pages• Make sure to read both pages• Parent MUST sign this form even if child is 18.

IMPACT ImPACT is a computerized test we use to baseline athletes in

case of a concussion. This test should be done FRESHMEN and JUNIOR years. Sports in which this test is required:

Baseball Basketball (Boy’s and Girl’s) Cheerleading (Fall and Winter) Football Ice Hockey Lacrosse Soccer (Boy’s and Girl’s) Softball Volleyball Wrestling

INSTRUCTIONS FOR IMPACT TESTING

Set aside 30 minutes in a quiet room with no distractions. No headphones or cell phones. Turn off TVs, radios, or any other background

noise. The test will begin with background questions called the “demographics”

section. Then the “modules” will begin, which consist of: word memory, design memory, X’s and O’s, symbol match, color word match, and three letters.

Read each section’s instructions carefully. To take the baseline test, go to www.impacttestonline.com/schools, select

“NJ” and then click “Launch Baseline Test.” Enter the customer code : E8B1929D28 and click “Launch Baseline Test.” Make sure Pop-ups are allowed or you will be redirected to the last page. Test results are not displayed once finished. Print out the completed test form. If you do not have access to the internet or a home computer, please contact

Jaime Dickerson to arrange a testing time at school.

COMPUTER REQUIREMENTS FOR IMPACT

Minimum computer requirements: Internet Explorer 6.0 or above, Firefox 1.5 or above, Safari for MAC

and OSX 10.2 or above. Macromedia Flash Player 8.0 or newer. It can be downloaded at

www.adobe.com Pop-up blocker must be turned off for the duration of the test. Close all other programs on your computer before taking the test. Broadband Internet connection required

ATHLETIC TRAINING PROCEDURES

All athletes are to report any and all injuries to Jaime Dickerson as soon as possible.

Once Jaime is notified, the proper paperwork will be completed.

If an athlete goes to the Doctor for an injury or illness, that athlete MUST give Jaime a note from that Doctor.

Any taping that needs to be done will take place after school. Away games will be taped first, then home games, and then practices.

Any athlete that needs to be seen for an injury will be seen after Jaime is done taping.

ATHLETIC TRAINING ROOM RULES

No “hanging out” in the Athletic Training Room after school. One or two people per team can get water. It is not

necessary for 5 people to do this. Cubbies are provided by the door, please put all personal

stuff there, so it is not on the floor where people will trip over it.

No cleats are allowed in the Athletic Training Room. If you come into the room in cleats, you must do 10 push-ups.

No cursing in the Athletic Training Room, if you curse, you must do 15 push-ups.

Jaime’s desk and everything on her desk is off limits, including her chair.

FOR ADDITIONAL INFORMATION

Please visit the athletics website for additional information on: Pay to Participate forms Physical Forms and Instructions ImPACT test instructions

WWW.NUTLEYSCHOOLS.ORG/ATHLETICS.ASPX