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Athletic Training Staff

 

 


                                                                     HEAD ATHLETIC TRAINER                                                                ATHLETIC TRAINER                          

                                                                                                                                                                           

                                                                                Jason M. Jenkins, M.S.E., ATC, LAT                                                                 Breezy Zambrano, MAT, ATC, LAT
                                                                                  Phone: (940) 552-6291 x. 2289                                                                       Phone: (940) 552-6291 x. 2283

 

 


 

STUDENT-ATHLETE MEDICAL FORMS

All forms must be signed and submitted before participation in any team activities (practice,games,etc.)

Please choose either the Word format or the PDF format. You DO NOT need to do both.

CLICK ON EACH FORM TO DOWNLOAD

VERNON COLLEGE HIPPA FORM (Word)

VERNON COLLEGE HIPPA FORM (pdf)

CONSENT TO TREAT FORM (Word)

CONSENT TO TREAT FORM (pdf)

VERNON COLLEGE PHYSICAL FORM (Word)

VERNON COLLEGE PHYSICAL FORM (pdf)

EMERGECNY CONTACT/INSURANCE INFORMATION (Word)

EMERGENCY CONTACT/INSURANCE INFORMATION (pdf)

HEALTH HISTORY FORM (Word)

 HEALTH HISTORY FORM (pdf)

VERNON COLLEGE DRUG TESTING FORM (Word)

VERNON COLLEGE DRUG TESTING FORM (pdf)

 

PLEASE HAVE ALL FORMS COMPLETED AND SENT PRIOR TO JULY 18, 2025

 DO NOT EMAIL THESE FORMS! SEND THEM VIA THE MAIL!!

ALL FORMS NEED TO BE SENT TO:

VERNON COLLEGE

ATTN: JASON JENKINS, ATC

4400 COLLEGE DRIVE

VERNON, TX   76384

 

 


 

To the Athletic Training Student Applicant:

 

The following is a list of requirements for acceptance into the Vernon College Athletic Training Program: 

Become accepted to Vernon College                     Completed Athletic Training application


Site visit and interview with the Head Athletic Trainer

 

Click on the link below for more details about the application process.

BECOME A STUDENT ATHLETIC TRAINER