Free Alabama High School Physical PDF Template Fill Out This Document Now

Free Alabama High School Physical PDF Template

The Alabama High School Physical form is a crucial document that ensures student-athletes are medically fit to participate in sports. It collects essential health information and requires a physician's evaluation to confirm that the athlete is cleared for participation. Completing this form is vital for safeguarding the health of young athletes, so be sure to fill it out by clicking the button below.

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Outline

The Alabama High School Physical Form plays a crucial role in ensuring the safety and well-being of student-athletes participating in interscholastic sports. This form requires detailed information about the athlete, including their name, age, address, and school grade. It also includes a comprehensive medical history section, where questions address past injuries, medical conditions, and any ongoing health issues. Athletes must disclose any history of surgeries, allergies, or chronic illnesses, such as asthma or diabetes, which could impact their ability to participate in sports. Additionally, the form mandates a physical examination by a licensed physician, who must certify that the student is fit to engage in athletic activities. The physician's evaluation includes an assessment of the athlete's cardiovascular health, musculoskeletal system, and overall physical condition. This thorough process not only helps in identifying any potential health risks but also ensures that all students are cleared for safe participation in sports. The form must be kept on file at the school, reaffirming the importance of maintaining accurate and up-to-date health records for all student-athletes.

Documents used along the form

When preparing for participation in high school athletics in Alabama, several important documents accompany the Alabama High School Physical form. These documents help ensure that athletes are in good health and ready to compete safely. Below is a list of commonly required forms and documents that may be needed alongside the physical evaluation.

  • AHSAA Consent Form: This form is used to obtain permission from a parent or guardian for a student athlete to participate in sports. It outlines the risks involved and ensures that the parent or guardian is aware of the athlete's participation.
  • Medical History Form: This document collects detailed information about the athlete's past medical conditions, surgeries, and any ongoing treatments. It helps the healthcare provider assess the athlete's fitness for sports.
  • Emergency Contact Form: This form provides essential information regarding whom to contact in case of an emergency. It typically includes the names and phone numbers of parents or guardians, as well as any additional emergency contacts.
  • Insurance Information Form: This document gathers details about the athlete's health insurance coverage. It is crucial for addressing any medical expenses that may arise from injuries sustained during sports activities.
  • Concussion Awareness Form: This form educates athletes and their guardians about the risks of concussions. It requires signatures from both the athlete and a parent or guardian, acknowledging their understanding of concussion symptoms and protocols.
  • Firearm Bill of Sale: Required for the legal transfer of ownership of a firearm, ensuring both parties' protection and clarity during the transaction. For more details, refer to the Bill of Sale for a Gun.
  • Waiver of Liability: This document releases the school and its staff from liability in the event of an injury. It emphasizes the inherent risks associated with sports participation and requires a signature from the athlete and a parent or guardian.
  • Physical Examination Report: This report is completed by the examining physician and certifies that the athlete has passed a physical exam. It includes findings from the examination and any recommendations for participation.

These forms collectively ensure that athletes are physically prepared and that their health and safety are prioritized. Completing these documents accurately and submitting them on time is essential for a smooth athletic experience.

Steps to Filling Out Alabama High School Physical

Filling out the Alabama High School Physical form is an essential step for students participating in athletics. This form requires accurate information about the athlete's medical history and physical examination results. Completing it correctly ensures that the student is cleared for participation in sports.

  1. Begin by entering the athlete's name, sex, and age at the top of the form.
  2. Fill in the address and school the athlete attends.
  3. Indicate the athlete's grade and the sport they plan to participate in.
  4. Answer the medical history questions. For each question, mark yes or no as appropriate. Be thorough, especially for any past injuries or conditions.
  5. If you answered yes to any questions, provide detailed explanations in the space provided.
  6. Record the date of birth and phone number of the athlete.
  7. Have the athlete sign and date the form, confirming that their answers are correct.
  8. Next, a parent or guardian must sign and date the form as well.
  9. After the medical history section, a physician must conduct a physical examination and complete the corresponding section on the form.
  10. The physician will indicate whether the athlete is cleared or not cleared for participation, along with any recommendations or restrictions.
  11. Finally, ensure the physician includes their name, signature, address, and phone number.

Misconceptions

Misconceptions about the Alabama High School Physical form can lead to confusion among athletes, parents, and school officials. Here are six common misconceptions explained in detail:

  • Physical exams are only required for new athletes. Many believe that only first-time athletes need to complete the physical form. In reality, all students participating in interscholastic athletics must submit a current physical examination every year, regardless of prior participation.
  • Any doctor can perform the physical exam. Some assume that any healthcare provider can complete the required physical. However, the examination must be conducted by a licensed physician (M.D. or D.O.) to ensure that the evaluation meets the standards set by the Alabama High School Athletic Association (AHSAA).
  • Once a physical is completed, it never needs to be updated. There is a misconception that a physical remains valid indefinitely. In fact, the findings from the physical examination are only valid for one calendar year from the date of the exam. Athletes must have a new physical each year to maintain eligibility.
  • Only the athlete needs to sign the form. Some believe that only the student athlete's signature is necessary. However, both the athlete and a parent or guardian must sign the form to confirm the accuracy of the information provided and to acknowledge consent for participation.
  • The physical form is optional for certain sports. Many think that the physical evaluation is not required for non-contact sports. This is incorrect. All sports, whether contact or non-contact, require a completed physical form to ensure the health and safety of all participants.
  • Previous injuries do not need to be disclosed. It is a common misconception that athletes can omit past injuries from the physical form. In truth, all previous injuries and medical conditions must be disclosed to give the examining physician a complete understanding of the athlete's health history.

Understanding these misconceptions can help ensure that all athletes are properly prepared and eligible for participation in their chosen sports. Accurate information and compliance with the requirements are essential for the safety and well-being of student athletes.

Form Sample

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.)