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  • Health Assessment Sports Physical Statement Hasps For Cys

Get Health Assessment Sports Physical Statement Hasps For Cys

Health Assessment / Sports Physical Statement (HASPS) for CYS SERVICES ENROLLEMENT, Renewal & SPORTS Physical Requirements Revised 12Jan 10 DATA REQUIRED BY THE PRIVACY ACT OF 1994 PRINCIPAL PURPOSE:.

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How to fill out the Health Assessment Sports Physical Statement HASPS For CYS online

Completing the Health Assessment Sports Physical Statement (HASPS) for Child and Youth Services (CYS) online can be a straightforward process if you follow the steps outlined in this guide. This document is essential for verifying your child's health status and ensuring their readiness for sports and other activities.

Follow the steps to complete the HASPS online.

  1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
  2. Begin with Part A, which requires medical history information. Fill in the sponsor's name, contact numbers, and address. Enter your child's name, date of birth, and gender, ensuring to choose between male or female.
  3. Indicate whether your child has ongoing medical concerns and if they are enrolled in the Exceptional Family Member Program by selecting 'Yes' or 'No' and providing explanations if necessary.
  4. Complete the medical history section by answering the questions about hospitalization, allergies, delays, and any ongoing medications. For each 'Yes' response, provide additional details as requested.
  5. Move to Part B, where a licensed healthcare professional will need to fill out the physical exam section. Ensure they assess the relevant medical parameters and provide their comments on each examination area.
  6. In the participation recommendations section, the healthcare provider should confirm if your child can participate in all sports and provide any restrictions or comments.
  7. Complete Part C by describing any special medical considerations your child may need to participate in CYS programs. The licensed health care professional will need to sign and stamp this section.
  8. Finally, ensure that both the parent or guardian and the healthcare professional sign the document where indicated before saving your changes.
  9. Once all sections are filled out, you can save the form, download it for your records, print it, or share it as required.

Start completing the Health Assessment Sports Physical Statement HASPS online today to ensure your child's participation in sports and activities.

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CODE DESCRIPTION. Initial comprehensive preventive evaluation and management of an individual, including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; Code: 99394.

If you provide independent medical examinations (IMEs), the specific codes for a "work-related or medical disability examination" are either CPT 99455 (by the treating physician) or CPT 99456 (by other than the treating physician).

CPT code 99212 and diagnosis code Z02. 5 should be used to bill for a sports physical. No additional modifier is needed.

ICD-10 code Z02. 5 for Encounter for examination for participation in sport is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

Physicals should be performed yearly and often for adolescents before entrance into sports. The doctor will examine the eyes, ears, nose, throat, mouth, abdomen, back, legs, arms, and thyroid gland. In addition, the doctor will complete an assessment of growth and evaluate pubertal changes.

The ICD-10 diagnosis code(s) for the problem visit must be listed as the primary diagnosis code(s) and the Z02. 5 for the Preparticipation Physical Evaluation (Z02. 5 (examination for participation in sport) must be listed after all other diagnosis code(s).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232