Get Confidential Athletic Pre-participation Physical Examination

Completing the CONFIDENTIAL ATHLETIC PRE-PARTICIPATION PHYSICAL EXAMINATION is essential for students wishing to participate in athletic activities. This guide will provide you with clear, step-by-step instructions on how to fill out the form accurately and effectively.

Follow the steps to complete the examination form online.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering the student's personal details in the appropriate fields, including their name, home address, phone number, parent’s name, family physician, current school, date, grade, and date of birth. Ensure all information is accurate and clearly printed.
3. In the questionnaire section, answer each question honestly by selecting 'Yes' or 'No.' For questions answered 'Yes,' provide explanations in the designated area. If you are uncertain about any question, circle it for further discussion with a medical professional.
4. For female students, complete the additional questions regarding menstrual periods as required. Use the space provided to note any relevant information.
5. Fill in the allergies and immunizations section, detailing any known allergies and listing the dates of relevant vaccinations. This information is crucial for ensuring the student's health and safety during athletic activities.
6. Once the history section is complete, the licensed medical professional will need to conduct a physical examination. They will record their findings in the provider’s physical examination form by entering the student’s weight, height, blood pressure, and other pertinent information.
7. The medical provider will mark the clearance status, indicating whether the student is cleared for participation, with or without restrictions, or not cleared at all, along with any recommendations for treatment or further evaluation.
8. The final section requires the parent or guardian's permission and release statement. The parent must ensure the information is accurate, type or print their name, and provide their signature, date, and contact information.
9. After all areas have been completed and reviewed, users can save changes, download, print, or share the completed form as needed.

Complete your athletic pre-participation physical examination form online today for a smooth entry into sports activities.