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NUHealth-History-New18

NUHealth-History-New18 2026

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The document is a comprehensive health history questionnaire for new student-athletes at Northwest University, designed to assess their medical history and potential health risks related to athletic participation. It includes sections on cardiovascular risk factors, allergies, asthma, head injuries, heat-related problems, diabetes, and various physical injuries. The information collected is confidential and used solely by the Athletic Training and Sports Medicine Department to ensure the safety of the athletes. Additionally, it contains authorization for the use and disclosure of protected health information and a medical examination waiver.

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Click ‘Get Form’ to open the NUHealth-History-New18 in the editor.
Begin by filling out your personal information at the top of the form. Ensure that you type or print clearly in blue or black ink as specified.
Proceed to Section I, where you will answer questions regarding cardiovascular risk factors. Select 'YES' or 'NO' for each question based on your medical history.
Continue through each section, including allergies, asthma, head injuries, and other health-related inquiries. Be thorough and provide additional details where prompted.
Once all sections are completed, review your answers for accuracy before signing at the end of the document. This ensures that all information is correct and complete.

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