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department of athletics policies & procedures - UNC Wilmington ...

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Epilepsy /seizures Y N<br />

Anorexia/bulimia Y N<br />

Bleeding problems (free bleeding, hemophilia) Y N<br />

Sickle cell anemia/sickle cell trait Y N<br />

Hernia Y N<br />

Been told you have a heart murmur or heart problem or rheumatic fever Y N<br />

Been told you have Marfan’s Syndrome Y N<br />

Whole body/severe/shock allergic reaction to bee stings, food, other Y N<br />

Have you used/do you use performance enhancing substances or drugs? Y N<br />

Has a doctor ever advised you not to participate in <strong>athletics</strong>? Y N<br />

Female athletes only:<br />

Are your menstrual periods regular and monthly? Y N<br />

When did you last menstrual period begin?<br />

What was the longest time between your periods in the last year?<br />

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