On behalf of Jackson Community College and Allegiance Sport Medicine, I would like to welcome you to Jackson Community College Athletics. Sports Medicine coverage here at Jackson Community College is contracted through Allegiance Sport Medicine and consists of a team physician and a full-time Certified Athletic Trainer. Our focus is to address the sports medicine needs of each student-athlete through prevention, evaluation, management, rehabilitation, and referral of athletic injuries and/or illnesses. Our primary concern is to maintain the health and safety of every student-athlete while participating in Jackson Community College athletics.
The following documents are Essential in our efforts to provide optimal healthcare for Jackson Community College student-athletes.
- Insurance Information Form - Please fill out form completely and attach a copy of your insurance card(s) (front & back). Please be aware that Jackson Community College requires each student-athlete to have Primary Health Insurance. Student-athletes that do not return Insurance Information Form or provide proof of existing insurance coverage will not be able to participate in any practices or games until they do so.
Pre-Participation Physical Examination Form - Please answer ALL medical
history questions honestly and accurately. Please be certain to provide
signature(s) on bottom of physical form. The physical examination must be
performed by Jackson Community College’s Team Physician. Teams will be
assigned dates to attend JCC for their physical over the summer prior to
If you are unable to attend your assigned date it will be your responsibility to call Allegiance Sport Medicine and set up a physical appointment. If you have to go into the clinic for your physical it will cost you $30.
- Medical Consent to Treat and Release of Information Form - Please read form carefully, then print, sign and date form.
Please ensure that all forms are fully completed and legible. It is imperative that all information is accurate and that all appropriate signatures are included. Please bring all completed forms with you to your designated physical date listed above.
Jill Williams, ATC
Athletic Trainer - Jackson Community College
517-796-8447 | email@example.com