Required Forms for Clearance
The Required Forms for Athletic Clearance at Farmingdale
Medical History Form - New or Transfers
Medical History Update Form - Returning Players
1. College Physical Examination Form (download above)...preferably to be completed by your own physician.
Note: Physical examinations, related diagnostic tests, and immunizations are available at the Health and Wellness Center for reduced fees.
2. EKG (electrocardiogram), on which your physician specifies is within normal limits. Copy must be attached.
3. Written clearance from your physician to participate in athletics.
4. Medical History Form (download
5. Insurance (download above)
1. College Physical Examination
Form (download above or at http://www.farmingdale.edu/campus-life/student-support-services/pdf/health-record-form-3-2012.pdf)
Note: If you have ever had a cardiac referral for an abnormal EKG, you will need a repeat EKG each year you participate.
2. Medical History Update Form (download above)
3. Insurance (download above)
Required for ALL ATHLETES
Free EKGs are available by appointment at Health & Wellness Center.
If you are having your physical examination here and need the EKG, it must be done at least one week prior to the physical examination.
All athletes are required by the FSC athletic department to get an EKG. Athletes WILL NOT be allowed to participate in any sport without a physical and passing an EKG.
Please call for appointment during our scheduled clinics.
If you are having a complete entrance physical examination, you must bring copies of your immunization records with you.
PLEASE CALL THE HEALTH & WELLNESS CENTER FOR ALL APPOINTMENTS: (631) 420-2009
Note: Returning student-athletes will not require an EKG. If they are not added to the current team roster, they will be charged a fee for their physical. Only if your name is on the list at the center will you be allowed to get a free physical.
All athletes are required to have medical insurance. If the athlete's insurance waiver omits a parental insurance coverage, they will be asked to obtain the school insurance for a fee.
The insurance coverage from the school is Columbia Mutual Life Insurance Plan.
For an outline of the Columbia Mutual Life coverage see their website: