Get Pre-participation Physical Form (pdf) - Archbishop Mitty High School

This guide provides clear and comprehensive instructions for completing the Pre-Participation Physical Form required by Archbishop Mitty High School. By following these steps, users can ensure that they accurately provide the necessary information for sports participation.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to obtain the Pre-Participation Physical Form and open it in your PDF viewer.
2. Begin by filling in the date of the examination, your full name, grade level (9, 10, 11, or 12), and date of birth. Ensure accuracy, as this information is vital.
3. Provide your address, city, zip code, and phone number. This contact information is essential for communication regarding your physical evaluation.
4. Fill in the emergency contact information, including their name, relationship to you, and their phone numbers (home and work). Ensure that this person is aware they might be contacted in case of an emergency.
5. Indicate your school and the sport(s) you intend to participate in during the academic year. This helps in organizing sports teams and activities.
6. List your personal physician's name, contact number, and address. If you have a preferred hospital for emergencies, include that information as well.
7. Fill out the insurance information, including the insurance company name, policy number, and type of insurance. Circle whether you have HMO or PPO insurance. This form ensures you have medical coverage during events.
8. Proceed to respond to the series of yes/no questions regarding your medical history. Circle or highlight any questions you are unsure about and be sure to address any 'yes' answers in the provided explanations.
9. For female users, additional questions regarding the menstrual history should be answered accordingly. This includes the age of first period and the number of periods in the last year.
10. Both the athlete and parent/guardian must sign the form, indicating readiness and understanding of the information provided. Ensure that the date is filled out next to each signature.
11. Have the form completed by a medical professional where indicated. This professional must complete and sign the physical examination section for the form to be valid.
12. Finally, save any changes made to the form, and you may download, print, or share it as needed for submission.

Complete the Pre-Participation Physical Form online now to ensure your eligibility for sports activities.