SATISFACTION SURVEY
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⇒Watch, how Atrium Health (formally Carolinas HealthCare Systems) is ensuring that Charlotte-Mecklenburg students stay safe on the field, on the court and in their everyday lives.
Provide “Athletic Training Services”* to student athletes under the direction of the team physician or by written referral from a physician, and in accordance with state athletic training practice act.
The management and provision of care of injuries to a physically active person as defined in the state practice act with the direction of a licensed physician. The term includes the rendering of emergency care, development of injury prevention programs and providing appropriate preventative and devices for the physically active person. The term also includes the assessment, management, treatment, rehabilitation and recondition of the physically active person whose conditions are within the professional preparation and education of a certified athletic trainer. The term also includes the use of modalities such as mechanical stimulation, heat, cold, light, air, water, electricity, sound, massage and the use of therapeutic exercises, reconditioning exercise and fitness programs.
Through the agreement between CMS and Atrium, these forms implemented to prevent any type of liability issue to protect both the safety of our student athlete and of our Athletic Trainer.
FORM 1: I prefer Novant facilities, why would I sign this? The Certified Athletic Trainer (ATC) at HHS is an employee of Atrium Health therefore it is a Atrium form. Medical facility preference should be noted in the eligibility packet. This form is strictly for the ATC to treat your student-athlete(s).
FORM 2: Why should I sign a release of my child’s health records? The areas highlighted in teal are the only portions that need to be filled in. This form allows the ATC to communicate on the behalf of you and your family to the coach, guidance office, and teachers regarding an injury sustained by your student-athlete. Our ATC does NOT have access to your health records, solely the records reported from medical treatment for said injury. Without signing this the student-athlete could potentially be further injured due to no communication between ATC and coaching staff.
ATHLETES CANNOT RETURN TO SPORT FOLLOWING A PHYSICIAN APPOINTMENT UNTIL ALL TESTING IS WITHIN NORMAL LIMITS, CLEARANCE NOTE IS SUBMITTED AND THEY HAVE PROGRESSED THROUGH THE FUNCTIONAL EXERTIONAL TESTING PROTOCOL IN THE EVENT IT IS CLEARANCE FOR A CONCUSSION. THEY ALSO MUST HAVE SUBMITTED GFELLAR-WALLER STATE MANDATED PAPERWORK TO ATHLETIC TRAINER SIGNED BY PROPER PHYSICIAN FOR CONCUSSIONS. A MEMBER OF THE ATHLETIC TRAINING STAFF HOLDS THE RIGHT TO OVERRULE A PHYSICIANS ORDERS IF THEY BELIEVE THE ATHLETE IS NOT READY TO RETURN OR CONTINUE THEIR SPORT.
Dr. Matt Gullickson, MD
Orthopedic Team Physician
OrthoCarolina Matthews
710 Park Center Dr.
Matthews, NC 28105
► For an appointment please call (704) 323-3000. Please state that you are a Providence student-athlete.
Dr. Catherine Rainbow, MD
Family Practice Physician/Sports Medicine
Sports Medicine & Injury Care Center – Ballantyne
14214 Ballantyne Road, Suite 105
Charlotte, NC 28277
► For an appointment please call (704) 863- HURT (4878), and request Dr. Catherine Rainbow. Please state that you are a Providence High School student-athlete.
Dr. David Wiercisiewski, MD
Physical Medicine & Rehabilitation Physician
Carolina Neurosurgery & Spine Associates – Charlotte
225 Baldwin Avenue
Charlotte, NC 28204
Phone: 704-376-1605
* For other SMIC locations, please click here.
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