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The Alabama High School Physical form is an essential document for students participating in athletics. This form ensures that young athletes are physically capable of engaging in sports safely. It includes a comprehensive preparticipation physical evaluation, which assesses the athlete's medical history and current health status. Key sections of the form require information about the athlete’s name, age, school, and grade, as well as a detailed medical history. Parents or guardians must provide insight into any past injuries, surgeries, or medical conditions that could affect the athlete's performance. The physical examination itself covers various aspects, including cardiovascular health, musculoskeletal condition, and overall physical fitness. Additionally, a licensed physician must sign the form, certifying that the student is cleared for participation in interscholastic athletics. This certification is valid for one calendar year, ensuring that athletes remain healthy and fit for their sports activities.

Common mistakes

  1. Failing to provide complete personal information, such as name, address, and date of birth.

  2. Not checking the correct sex box, which can lead to confusion during the evaluation.

  3. Overlooking the section about medical history, including past injuries or surgeries.

  4. Forgetting to explain any "Yes" answers in the medical history section, which is crucial for the physician's review.

  5. Neglecting to include the date of the last physical exam, which is necessary for compliance.

  6. Not obtaining the required signatures from both the athlete and the parent/guardian.

  7. Failing to provide a contact number for the physician, which is needed for any follow-up questions.

  8. Not indicating the sport the student will participate in, which is important for specific evaluations.

  9. Leaving the evaluation section incomplete, which can result in delays or disqualification.

  10. Submitting the form without ensuring that all sections are filled out correctly, which may lead to rejection.

Preview - Alabama High School Physical Form

ALABAMA HIGH SCHOOL ATHLETIC ASSOCIATION

Revised 2018

Revised 2018

Preparticipation Physical Evaluation Form

 

History

Date_______________________

Name__________________________________________________ Sex ________ Age______ Date of birth _______________

Address ______________________________________________________________________ Phone______________________

School ________________________________________________________Grade __________ Sport ______________________

Explain “Yes” answers below:

 

 

 

 

 

Yes

No

1.

Has a doctor ever restricted/denied your participation in sports?

 

 

 

 

 

2.

Have you ever been hospitalized or spent a night in a hospital?

 

 

 

 

 

 

Have ever had surgery?

 

 

 

 

 

 

 

 

3.

Do you have any ongoing medical conditions (like Diabetes or Asthma)?

 

 

 

 

4.

Are you presently taking any medications or pills (prescription or over‐the‐counter?

 

5.

Do you have any allergies (medicine, pollens, foods, bees or other stinging insects)?

 

6.

Have you ever passed out during or after exercise?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you ever been dizzy during or after exercise?

 

 

 

 

 

 

 

 

Have you ever had chest pain or discomfort in your chest during or after exercise?

 

 

Do you tire more quickly than your friends during exercise?

 

 

 

 

 

 

 

Have you ever had high blood pressure?

 

 

 

 

 

 

 

 

Have you ever been told that you have a heart murmur, high cholesterol, or heart infection?

 

 

Have you ever had racing of your heart or skipped heartbeats?

 

 

 

 

 

 

Has anyone in your family died of heart problems or a sudden death before age 50?

 

 

Does anyone in your family have a heart condition?

 

 

 

 

 

 

 

Has a doctor ever ordered a test on your heart (EKG, echocardiogram)?

 

 

 

 

7.

Do you have any skin problems (itching, rashes, staph, MRSA, acne)?

 

 

 

 

 

8.

Have you ever had a head injury or concussion?

 

 

 

 

 

 

 

 

Have you ever been knocked out or unconscious?

 

 

 

 

 

 

 

 

Have you ever had a seizure?

 

 

 

 

 

 

 

 

 

Have you ever had a stinger, burner, pinched nerve, or loss of feeling or weakness in your arms or legs?

 

9.

Have you ever had heat or muscle cramps?

 

 

 

 

 

 

 

 

Have you ever been dizzy or passed out in the heat?

 

 

 

 

 

 

10. Do you have trouble breathing or do you cough during or after activity?

 

 

 

 

 

Do you take any medications for asthma (for instance, inhalers)?

 

 

 

 

 

11. Do you use any special equipment (pads, braces, neck rolls, mouth guard, eye guards, etc.)?

 

12. Have you had any problems with your eyes or vision?

 

 

 

 

 

 

 

Do you wear glasses or contacts or protective eye wear?

 

 

 

 

 

 

13. Have you had any other medical problems (infectious mononucleosis, diabetes, infectious diseases, etc.)?

 

14. Have you had a medical problem or injury since your last evaluation?

 

 

 

 

 

15. Have you ever been told you have sickle cell trait?

 

 

 

 

 

 

 

 

Has anyone in your family had sickle cell disease or sickle cell trait?

 

 

 

 

 

16. Have you ever sprained/strained, dislocated, fractured, broken or had repeated swelling or other

 

 

injuries of any bones or joints?

 

 

 

 

 

 

 

 

 

Head

Back

Shoulder

Forearm

Hand

Hip

Knee

Ankle

 

 

Neck

Chest

Elbow

Wrist

Finger

Thigh

Shin

Foot

 

17.When was your first menstrual period?__________________________________________________________________

When was your last menstrual period?___________________________________________________________________

What was the longest time between your periods last year?________________________________________________

Explain “Yes” answers:

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

I hereby state that, to the best of my knowledge, my answers to the above questions are correct.

Signature of athlete ___________________________________________________________ Date ___________________

Signature of parent/guardian __________________________________________________

FORM 5

DUPLICATE AS NEEDED

Rev. 2018 (The revised 2018 form is the official form accepted by the AHSAA.)

Page 1 of 2

Preparticipation Physical Evaluation Rule 1, Sec. 14 — In order for a student to be eligible for interscholastic athletics, there must be

on file in the Superintendent’s or Principal’s office a current physician’s statement certifying that

__________________________________________ the student has passed a physical exam, and that in the opinion of the examining physician (M.D.

 

 

 

Student's name

or D.O.) the student is fully able to participate in interscholastic athletics (Grade s 7‐12). The

 

 

 

AHSAA Physicians Certificate (Form 5 Rev. 2018) must be used. A physical exam will satisfy the

 

 

 

 

 

Physical Examination

requirement for one calendar year through the end of the month from the date of the exam. For

example, a physical given on May 5, 2019, will satisfy the requirement through May 31, 2020.

 

 

 

 

 

 

 

 

 

 

Height ____________ Weight _____________ BP _____ / _____ Pulse ____________

 

 

 

 

Vision R 20 / ____ L 20 / ____ Corrected: Y N

Revised 2018

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIMITED

 

Normal

 

 

Abnormal Findings

 

 

 

 

 

 

 

 

 

 

 

Cardiovascular

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pulses

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Heart

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lungs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Skin

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E.N.T.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETE

 

Abdominal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Genitalia (males)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Musculoskeletal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Neck

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shoulder

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Elbow

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wrist

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hand

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Back

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Knee

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ankle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Foot

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clearance:

A.Cleared

B.Cleared after completing evaluation/rehabilitation for: _______________________________________

C. Not cleared for:

Collision

 

 

 

Contact

 

 

 

Noncontact ____ Strenuous

____ Moderately strenuous

____ Nonstrenuous

Due to: ____________________________________________________________________________________________

Recommendation: _________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Name of physician ________________________________________________________________ Date ____________________

Address ________________________________________________________________________ Phone___________________

.

Signature of physician _____________________________________________________________, M.D. or D.O.

(Form must be signed and dated by the attending physician.)

Rev. 2018 (The revised 2018 form is the official form accepted by the AHSAA.)

Documents used along the form

When it comes to participating in high school athletics in Alabama, the Alabama High School Physical form is just one piece of the puzzle. Several other forms and documents are often required to ensure that students are safe and prepared for their sports activities. Here’s a brief overview of some of these important documents.

  • Medical History Form: This form provides detailed information about a student’s past medical conditions, surgeries, and any ongoing health issues. It helps the physician assess the athlete's readiness to participate in sports.
  • Consent to Treat Form: This document allows medical personnel to provide treatment to the athlete in case of an injury or emergency during practice or games. It ensures that parents or guardians are informed and have given their permission for medical care.
  • Insurance Information Form: This form collects details about the athlete's health insurance coverage. It is essential for medical providers to know how to process any claims in case the athlete requires medical attention.
  • Emergency Contact Form: This document lists individuals to contact in case of an emergency involving the athlete. It typically includes names, phone numbers, and relationships to the athlete.
  • Mobile Home Bill of Sale: To ensure a smooth transition of ownership during the sale of a mobile home, it's crucial to complete the necessary documentation accurately. For detailed guidance, refer to the Mobile Home Bill of Sale.
  • Participation Agreement: This agreement outlines the expectations and responsibilities of the athlete and their parents. It often includes rules about conduct, attendance, and commitment to the team.
  • Concussion Awareness Form: This form educates athletes and parents about the signs and symptoms of concussions. It often requires signatures to acknowledge understanding of the risks associated with head injuries.
  • Sudden Cardiac Arrest Awareness Form: Similar to the concussion form, this document raises awareness about the risks of sudden cardiac arrest in young athletes. It ensures that parents and athletes are informed about the warning signs and necessary precautions.
  • Drug Testing Consent Form: For certain sports, schools may require athletes to consent to drug testing. This form outlines the testing process and the substances that may be tested for, ensuring compliance with school policies.

Completing these forms is crucial for the safety and well-being of student-athletes. They help ensure that everyone involved is informed and prepared for any situation that may arise during sports activities. Always check with your school’s athletic department for specific requirements and updates regarding these documents.

Similar forms

The Preparticipation Physical Evaluation (PPE) form is commonly used in various states and educational institutions to assess a student's readiness for sports participation. Similar to the Alabama High School Physical form, the National Federation of State High School Associations (NFHS) PPE form gathers comprehensive medical history and physical examination results. It includes sections for previous injuries, chronic conditions, and current medications, ensuring that the student athlete is safe to engage in sports activities. The NFHS form is widely recognized and accepted across many states, providing a standardized approach to evaluating student athletes.

The NCAA Sports Physical form is another document that parallels the Alabama High School Physical form. This form is specifically designed for college athletes and requires a thorough medical history and physical examination. Like the Alabama form, it assesses any prior injuries or medical conditions that could affect an athlete's performance. The NCAA form emphasizes the importance of a physician's evaluation to ensure that student athletes are fit for competition at the collegiate level, making it a critical document for aspiring college athletes.

The Wisconsin Motorcycle Bill of Sale form is a crucial legal document that aids in documenting the sale or transfer of a motorcycle, ensuring both the seller and the buyer are protected during the transaction. This is essential for providing evidence of ownership change and is particularly important for registration and tax purposes. For more information on the form, you can visit https://autobillofsaleform.com/motorcycle-bill-of-sale-form/wisconsin-motorcycle-bill-of-sale-form.

The AHA (American Heart Association) Preparticipation Screening form is also similar in nature. This document focuses on cardiovascular health and includes questions about family history of heart conditions, symptoms experienced during exercise, and previous heart issues. While the Alabama High School Physical form covers a broader range of health concerns, the AHA form specifically targets heart-related issues, which are essential for ensuring the safety of athletes during physical activities.

The UIL (University Interscholastic League) Physical Examination form used in Texas is comparable to the Alabama form in that it also requires a physician's signature certifying that a student athlete is fit to participate in sports. This form collects detailed medical history and includes a physical exam section. Like the Alabama High School Physical form, the UIL form aims to protect student athletes by ensuring they meet health standards before engaging in competitive sports.

The AAP (American Academy of Pediatrics) Sports Physical form is another document that shares similarities with the Alabama High School Physical form. This form is designed to evaluate the health of children and adolescents participating in sports. It includes sections on medical history, physical examination, and recommendations for participation. The AAP form emphasizes the importance of a comprehensive assessment, much like the Alabama form, to identify any potential health risks associated with sports participation.

The California Interscholastic Federation (CIF) Physical Examination form is also similar in purpose and structure. This form collects medical history and requires a physical examination to ensure that athletes are fit to participate in sports. The CIF form, like the Alabama High School Physical form, mandates a physician's clearance, ensuring that student athletes are evaluated for any health concerns that could arise during physical activity.

Finally, the Florida High School Athletic Association (FHSAA) Preparticipation Physical Evaluation form is another document that parallels the Alabama High School Physical form. This form gathers comprehensive medical history and requires a physical exam, similar to the Alabama form. It is designed to ensure that student athletes are safe to participate in sports, highlighting the importance of a thorough evaluation by a qualified physician. The FHSAA form underscores the commitment to athlete safety, aligning with the objectives of the Alabama High School Physical form.

Dos and Don'ts

When filling out the Alabama High School Physical form, it's important to ensure accuracy and completeness. Here are six essential tips to guide you through the process:

  • Do provide accurate personal information, including your name, age, and school.
  • Don't leave any questions unanswered; all sections must be filled out to avoid delays.
  • Do disclose any medical history, including past injuries or conditions, even if they seem minor.
  • Don't exaggerate or downplay your health issues; honesty is crucial for your safety.
  • Do have a parent or guardian review the form before submission to ensure everything is correct.
  • Don't forget to sign the form; both the athlete and a parent/guardian must provide their signatures.

Following these guidelines will help ensure that the physical evaluation process goes smoothly and that you are ready for participation in sports.

Key takeaways

When filling out the Alabama High School Physical form, keep these key takeaways in mind:

  • Complete All Sections: Ensure every section of the form is filled out accurately. This includes personal information, medical history, and the physical examination results.
  • Consult with a Physician: A licensed physician must conduct the physical examination. Only a doctor (M.D. or D.O.) can certify that the student is fit for participation in sports.
  • Understand the Validity Period: The physical exam is valid for one calendar year. Make a note of the exam date to ensure compliance with eligibility requirements.
  • Keep Copies: It’s important to keep a copy of the completed form. This can be useful for future reference or if the school needs documentation.

How to Use Alabama High School Physical

Completing the Alabama High School Physical form is essential for student-athletes seeking to participate in sports. This process ensures that all relevant health information is accurately documented. Follow these steps carefully to fill out the form correctly.

  1. Begin by entering your Name, Sex, and Age at the top of the form.
  2. Fill in your Address, School, and Grade in the designated spaces.
  3. Answer the health history questions thoroughly. Indicate any past or present medical issues by checking "Yes" or "No." Be honest about any injuries, surgeries, or conditions.
  4. If you answer "Yes" to any question, provide additional details in the space provided.
  5. Record your Date of Birth and Phone number.
  6. Select the Sport you intend to participate in from the list.
  7. Sign and date the form, confirming that your answers are accurate.
  8. Have a parent or guardian sign the form as well.
  9. Ensure that the form is completed and submitted to the appropriate school official.

After filling out the form, schedule a physical examination with a licensed physician. The physician will assess your health and provide clearance for participation in sports. Make sure to keep a copy for your records and submit the original to your school’s administration.