Norwich university department of athletics
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REPORTING FORMI, _________________________________, under the reasonable suspicion clause Name of Norwich University Athletic Dept. Staff Member
Name of Student-Athlete the Director of Athletics or his/her designee for possible drug testing. The following sign(s), symptom(s) or behavior(s) were observed by me over the past _____ hours and/or ______ days. Please check below all that apply: The Student-Athlete has shown: _____ irritability _____ loss of temper _____ poor motivation _____ failure to follow directions _____ verbal outburst (e.g. to faculty, staff, teammates) _____ physical outburst (e.g. throwing equipment) _____ emotional outburst (e.g. crying) _____ weight gain _____ weight loss _____ sloppy hygiene and/or appearance The Student-Athlete has been:
_____ late for class _____ not attending class _____ receiving poor grades _____ staying up too late _____ missing appointments _____ missing/skipping meal
The Student-Athlete has demonstrated the following: _____ dilated pupils _____ constricted pupils _____ red eyes _____ smell of alcohol on the breath _____ smell of marijuana _____ staggering or difficulty walking _____ constantly running and/or red nose _____ recurrent bouts with a cold or the flu (give dates ________ ) _____ over stimulated or “hyper” _____ excessive talking _____ withdrawn and/or less communicative _____ periods of memory loss _____ slurred speech _____ recurrent motor vehicle accidents and/or violations (give dates ________ ) _____ recurrent violations of Norwich University Student Code of Conduct Other specific objective findings include: __________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Signatures ______________________________ _______________________________ Print Name of Athletic Dept. Staff Signature of Athletic Dept. Staff Date Reviewed By: ________________________ ___________________________________________ Director of Athletics/Designee Date Counselor Consulted: _________________________________________________________________ Name of Counselor Consulted Date Consulted Reviewed by: ______________________________________________________________________ Dean of Students/ Commandants Date
Reasonable suspicion finding certified __________________________________________ Vice President of Student Affairs Date ON LINE SOCIAL NETWORKS The Department of Athletics recognizes the fact that many student-athletes participate in online social networks such as Facebook.com and Myspace.com. While there is nothing inherently dangerous about posting to these sites, sharing inappropriate information via the internet may put you at risk. When using online social networks, you should be mindful of the possible consequences:
2015-16 NCAA Banned Drugs 
It is your responsibility to check with the appropriate or designated athletics staff before using any substance The NCAA bans the following classes of drugs: a. Stimulants b. Anabolic Agents c. Alcohol and Beta Blockers (banned for rifle only) d. Diuretics and Other Masking Agents e. Street Drugs f. Peptide Hormones and Analogues g. Anti-estrogens h. Beta-2 Agonists
The institution and the student-athlete shall be held accountable for all drugs within the banned drug class regardless of whether they have been specifically identified. Drugs and Procedures Subject to Restrictions:
c. Local Anesthetics (under some conditions). d. Manipulation of Urine Samples. e. Beta-2 Agonists permitted only by prescription and inhalation. NCAA Nutritional/Dietary Supplements Warning: Before consuming any nutritional/dietary supplement product, review the product with the appropriate or designated athletics department staff! Dietary supplements, including vitamins and minerals, are not well regulated and may Cause a positive drug test result. Student-athletes have tested positive and lost their eligibility using dietary supplements. Many dietary supplements are contaminated with banned drugs not listed on the label. Any product containing a dietary supplement ingredient is taken at your own risk. Check with your athletics department staff prior to using a supplement Note to Student-Athletes: There is no complete list of banned substances. Do not rely on this list to rule out any supplement ingredient. Check with your athletics department staff prior to using a supplement. Stimulants: Some Examples of NCAA Banned Substances in Each Drug Class amphetamine (Adderall); caffeine (guarana); cocaine; ephedrine; fenfluramine (Fen); methamphetamine; methylphenidate (Ritalin); phentermine (Phen); synephrine (bitter orange); methylhexaneamine, “bath salts” (mephedrone); Octopamine; DMBA etc. exceptions: phenylephrine and pseudoephedrine are not banned. Anabolic Agents (sometimes listed as a chemical formula, such as 3,6,17-androstenetrione): Androstenedione; boldenone; clenbuterol; DHEA (7-Keto); epi-trenbolone; etiocholanolone; methasterone; methandienone; nandrolone; norandrostenedione; ostarine; stanozolol; stenbolone; testosterone; trenbolone; SARMS (ostarine); etc. Alcohol and Beta Blockers (banned for rifle only): alcohol; atenolol; metoprolol; nadolol; pindolol; propranolol; timolol; etc. Diuretics (water pills) and Other Masking Agents: bumetanide; chlorothiazide; furosemide; hydrochlorothiazide; probenecid; spironolactone (canrenone); triameterene; trichlormethiazide; etc. Street Drugs: heroin; marijuana; tetrahydrocannabinol (THC); synthetic cannabinoids (eg. spice, K2, JWH-018, JWH-073) Peptide Hormones and Analogues: growth hormone(hGH); human chorionic gonadotropin (hCG); erythropoietin (EPO); IGF-1; etc. Anti-Estrogens : anastrozole; tamoxifen; formestane; ATD, clomiphene; SERMS (nolvadez); etc. Beta-2 Agonists: bambuterol; formoterol; salbutamol; salmeterol; higenamine; norcoclaurine; etc. Additional examples of banned drugs can be found at www.ncaa.org/drugtesting. Any substance that is chemically related to the class, even if it is not listed as an example, is also banned! Information about ingredients in medications and nutritional/dietary supplements can be obtained by contacting the Resource Exchange Center, REC, 877-202-0769 or www.drugfreesport.com/rec password ncaa1, ncaa2 or ncaa3. It is your responsibility to check with the appropriate or designated athletics staff before using any substance. 63
Directory: information information -> Management and Marketing information -> Computer Science 101 October 13, 2016 information -> Student athlete handbook information -> Table of Contents Page information -> Policies and Procedures 40 – Eligibility information -> Procedures for Implementing and Managing the All-University Policy on Mobile Communication and Information Devices (Mobile cids) Policy University of Kansas Medical Center information -> Policies and Procedures 40 – Eligibility information -> Cacc director’s council may 24-25 2010 12 noon caesar’s, Atlantic City, nj Download 271.24 Kb. Share with your friends:
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