Forms

Sports Physical Packet Checklist

(Updated for 2020-21 school year)

  • Pre-Participation Physical Evaluation Form - MUST BE DATED AFTER JUNE 1, 2020
  • Athletic Consent Waiver Form (completed by parent/guardian)
  • Athletic Medical History Questionnaire Form (completed by parent/guardian)
  • Emergency Contact Form (completed by parent/guardian)
  • Concussion Information Form (completed by parent/guardian)
  • **Summer/Off Season Athletic Consent Waiver (completed by parent/guardian)

Physical Form (PDF)

COVID-19 and Pre-Season/Acclimatization Forms
All forms are completed on the Athlete Medical Portal.

  • Summer/Off-Season Athletic Consent Waiver (completed by parent/guardian)
  • COVID-19 Medical History Questionnaire and Waiver of Liability (completed by parent/guardian)
  • COVID-19 Daily Symptom Checklist (completed by parent or student with Parent supervision and completed every day before arriving to campus)

*As of June 1st, 2019, all physical forms MUST be submitted online via the Athlete Medical Portal. All forms are accessible to be complete online through the Athlete Medical Portal and the Physical Form that gets completed by the physician can be uploaded directly to the Athlete Medical Portal. Please refer to the instructions below. No paper forms will be accepted, no exceptions.
 

**As of June 1st, 2019, any student that does not have a physical completed and on-file with the St. Mary’s Ryken High School Athletic Department must complete a Pre-Season and Summer Workout Consent Form to participate in any SMR Athletic sanctioned event outside of the sports season (i.e., summer workouts, pre-season workouts, team lifting/conditioning). Please complete the form online through the Athlete Medical Portal. For incoming Freshmen/Transfers, please click on the link below for the paper form if you don't have your SMR ID number.

Logging Into Athlete Medical Portal


Instructions for how to access the Athlete Medical Portal is found in mySMR and located in the Forms tab.

Athlete Medical Portal

For questions or problems creating the profile or uploading the paperwork, please contact the Head Athletic Trainer David "DJ" Hayes, Athletic Trainer, at david.hayes@smrhs.org

If you have other athletic related questions, please contact either the coach listed or Athletic Director, Coach Jon Lombardo at jonathan.lombardo@smrhs.org

On Campus Physicals

St. Mary’s Ryken High School Athletics and Sports Medicine will be offering sports physicals on campus for a small fee of $20 (exact cash or check made payable to St. Mary’s Ryken High School). 

WHEN: Saturday August 1 and Saturday August 8.

TIME: 8 a.m. to Noon for both dates by appointment only.  Click here to sign-up for a time slot.

WHERE: Athletic Training Room on Lower Level of the Donnie Williams Center (enter through the main front doors and follow signs down to the lower level).

BRING:  A signed permission form (below), a face covering, and a signed COVID-19 Medical History Questionnaire and Waiver of Liability (can also be completed on the Athlete Medical Portal).

On Campus Physical
Parent Permission Form

Summer and Off-Season Athletic Consent Waiver
for Freshmen/Incoming Transfers ONLY