Get Medical Evaluation For Continued Participation In Physical Education Referral For Illness And Injury

Filling out the Medical Evaluation For Continued Participation In Physical Education Referral For Illness And Injury form is an important step in ensuring that a student can safely participate in physical activities following an illness or injury. This guide will provide clear, step-by-step instructions to assist you in completing the form effectively online.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the student's name in the designated field at the top of the form. Make sure to provide the accurate and full name of the student.
3. Next, fill in the student ID number, ensuring that it matches the ID used by the school.
4. Enter the current date when filling out the form to ensure that the evaluation is timely.
5. The following section must be completed by the medical practitioner. This includes entering the medical diagnosis relevant to the student's condition. It is essential to be precise and concise.
6. Indicate the date the student will be re-examined or when they may return to unrestricted physical activity. This is crucial for tracking recovery.
7. Assess the student’s ability to participate in various physical activities listed, marking ‘Yes’ or ‘No’ for each activity. This includes running, jogging, and various strength training exercises.
8. If the student is diagnosed with a concussion, complete the second page of the form. This involves specifying their ability to participate in cognitive and physical activities.
9. If any limitations are present, indicate the level of participation for each specified activity, categorizing them as full, limited, or none.
10. Include any recommended academic adjustments or supports for the student in both gym and classroom environments.
11. Ensure the medical practitioner signs the form, prints their name, and provides their contact information, including phone number and address.
12. Review the completed form for accuracy and completeness before sending it back to the patient, parent(s), or guardian(s) for submission.
13. Finally, save any changes made, and download or print the filled-out form if required for records or submission.

Complete your Medical Evaluation Referral online to ensure a seamless return to physical education.