The Alabama High School Physical Form, officially known as the Preparticipation Physical Evaluation Form, serves as a crucial document for assessing the health and physical capability of students looking to participate in interscholastic athletics. It requires detailed information from students, such as their medical history, and undergoes a comprehensive physical examination to ensure they are fit for athletic activities. Upon completion, this form, mandated by the Alabama High School Athletic Association (AHSAA), must be on file with school authorities to confirm the student's eligibility for sports participation.
Designed to ensure the health and safety of student-athletes, the Alabama High School Athletic Association (AHSAA) Preparticipation Physical Evaluation Form is a comprehensive document meticulously crafted to assess the physical and medical readiness of high school students for athletic participation. Capturing essential personal information such as name, sex, age, address, school, and grade, alongside a detailed medical history, this form serves as a cornerstone for mitigating risks associated with sports. The inclusion of a thorough physical examination section underscores the emphasis on identifying any potential health concerns that could impact a student's ability to engage safely in sports activities. From assessing musculoskeletal health to cardiovascular fitness, and ensuring clearance for participation based on the findings, the form acts as a safeguard, reflecting the AHSAA's commitment to maintaining the well-being of student-athletes. By requiring a signature from both the athlete and a guardian, it further reaffirms the shared responsibility between students, parents, and schools in prioritizing student health. Additionally, adherence to the AHSAA's stipulation that a current physician's statement be on file validates the physical exam's pivotal role in certifying athletes' readiness, thus encapsulating the rigorous yet essential nature of the preparticipation evaluation process in Alabama high schools.
ALABAMA HIGH SCHOOL ATHLETIC ASSOCIATION
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
LIMITED
Normal
Abnormal Findings
Cardiovascular
Pulses
Heart
Lungs
Skin
E.N.T.
COMPLETE
Abdominal
Genitalia (males)
Musculoskeletal
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.)
Filling out the Alabama High School Athletic Association’s Preparticipation Physical Evaluation Form is a critical step in ensuring that students are physically and medically safe to participate in sports. This process involves providing accurate health history information and undergoing a physical examination. By following these instructions, the form can be filled out thoroughly and correctly.
After the form is submitted and reviewed by the school, the student will be informed about their eligibility to participate in interscholastic athletics based on the physical examination results and the school's criteria. It is essential to complete this process well before the sports season begins to ensure participation is not delayed.
What is the purpose of the Alabama High School Athletic Association Preparticipation Physical Evaluation Form?
The Alabama High School Athletic Association Preparticipation Physical Evaluation Form is designed to ensure that students who want to participate in interscholastic athletics are medically fit to engage in sports activities. It serves to identify any potential risks to the athlete's health before they participate in sports, ensuring their safety and well-being.
Who needs to complete the Alabama High School Physical Form?
Any student in grades 7 through 12 who wishes to participate in interscholastic athletics within schools governed by the Alabama High School Athletic Association (AHSAA) must complete this form. This requirement helps to maintain a standard of health and fitness for all participating athletes.
How often does the physical evaluation need to be completed?
The physical evaluation must be completed annually. A physical exam satisfies the requirement for one calendar year from the date of the examination. This policy ensures that the health status of student-athletes is up-to-date and that they are continually fit to participate in their chosen sports.
What if a student answers "Yes" to any of the medical history questions?
If a student answers "Yes" to any questions in the medical history section, they are required to provide an explanation in the space provided. This information allows the evaluating physician to understand the student's medical history more comprehensively and determine any restrictions or accommodations that may be necessary.
Who is qualified to perform the physical evaluation?
The physical evaluation must be conducted by a licensed physician (M.D. or D.O.). The physician's certification that the student has passed the physical exam and is able to participate in interscholastic athletics is a crucial step in completing the form. This ensures that the evaluation is thorough and conducted by a professional who can accurately assess the student's medical fitness for sports participation.
What happens if a student is not cleared for participation?
If a student is not cleared for participation in interscholastic athletics, the examining physician will indicate the reasons and recommendations in the designated section of the physical form. This may include the type of activities the student is not cleared for, such as collision, contact, or noncontact sports, and any conditions that must be met for clearance. Following the physician's recommendations is essential for the student's health and safety.
Filling out the Alabama High School Physical form is a crucial step in ensuring a student's eligibility and safety in high school athletics. However, errors in completing this form can lead to unnecessary delays or even disqualifications. Here are ten common mistakes to avoid:
One mistake often seen is not fully completing the personal information section at the top of the form. Missing key details such as the student's full name, date of birth, or correct contact information can create confusion or delays in the processing of the physical form.
Another common error is skipping questions in the medical history section. This part of the form is designed to capture any health issues that could affect the student's ability to safely participate in sports. Leaving sections unanswered might lead to an incomplete assessment of the athlete's health risks.
Many guardians and students make the mistake of not detailing past medical concerns adequately. For example, if a question about prior injuries, surgeries, or medical conditions is answered with a simple "yes," but lacks an explanation, this does not give the medical assessor enough information to make an informed decision.
A lack of specificity when explaining any "yes" answers is another frequent oversight. Providing generic or vague explanations for a medical condition or injury history can be as limiting as not providing any information at all. Clear, concise, and specific details are crucial.
Forgetting to include information about any ongoing treatment or medication is another common error. This could include prescriptions, over-the-counter medications, or specialized therapy sessions and treatments that are currently being administered.
Another oversight is when students and guardians sign the form without thoroughly reviewing all sections for accuracy and completeness. Failing to double-check the information can lead to submission of erroneous or incomplete forms.
Incorrectly marking the clearance section at the bottom of the second page is a mistake that can directly affect the student's eligibility. This section is typically completed by the physician, and students or guardians filling this part out inadvertently might face delays or require re-examination.
Not updating the medical history section annually or whenever a new health issue arises is also problematic. Even if a previous form was filled out correctly, new or changing health conditions must be noted in each subsequent physical examination form to ensure ongoing safety in athletic participation.
Failing to attach or request additional documentation for conditions that require further explanation or clearance can also be a misstep. Some health issues might require a more detailed evaluation or a specialist’s input, which should be provided alongside the physical form whenever necessary.
Last but certainly not least, submitting the form past the deadline is a mistake that can entirely prevent a student from participating in athletics. Being mindful of the school or association's deadline for submission is crucial, as late forms are often not accepted, leaving students ineligible to compete or participate in sports activities.
Avoiding these common errors can streamline the physical examination process, ensuring that students are cleared for participation without unnecessary delays. More importantly, it helps safeguard the health and well-being of young athletes by providing medical professionals with comprehensive and accurate information.
Alongside the Alabama High School Physical Form, necessary for student athletes to participate in high school sports, several additional forms often come into play. These documents ensure comprehensive care, adherence to legal standards, and the holistic well-being of the student athlete. They create a detailed network supporting the health, eligibility, and safety of the young athletes engaging in high school sports programs.
These documents, when used in conjunction with the Alabama High School Physical Form, ensure a safe and disciplined environment for student athletes. They emphasize the importance of health, education, and ethical conduct in the realm of high school sports, thus providing an integrated approach to student athlete welfare.
The College Preparticipation Physical Evaluation (PPE) form closely mirrors the Alabama High School Athletic Association's form in both structure and content. Like its high school counterpart, the college PPE requires a detailed medical history, including questions about past injuries, hospitalizations, allergies, and chronic health conditions. This ensures that both high school and college athletes are medically fit to engage in sports activities, thus minimizing the risk of injury exacerbated by pre-existing conditions.
Employee Health Screenings for physically demanding jobs share similarities with the Alabama High School Physical form, particularly in assessing an individual's physical capability to perform specific job functions safely. Both forms evaluate musculoskeletal health, heart health, and overall physical fitness. Such screenings help to prevent workplace injuries by ensuring employees are physically capable of handling their assigned tasks.
The Pediatric Health Maintenance Visit form serves a similar preventative and health monitoring function as the high school physical form, albeit for a younger demographic. It assesses growth milestones, vaccination status, and potential developmental issues, mirroring the high school physical's emphasis on identifying health conditions that could affect participation in activities, including sports.
International Travel Health Forms, used by doctors to evaluate individuals before they travel abroad, also bear resemblance to the high school physical form. These forms focus on ensuring the traveler is up to date on vaccinations and assess for any health conditions that might be exacerbated by travel, similar to how the high school physical aims to ensure the athlete is fit for sports activities.
The Annual Wellness Visit form, typically used in geriatric medicine, while serving a different age demographic, has objectives similar to the Alabama High School Physical form. It aims to monitor health status, prevent disease, and ensure the safety of activities suited to the individual's health level, adapting the same preventative stance in health maintenance.
Military Entrance Processing Station (MEPS) Physical Assessment forms, required for enlistment into the U.S. military forces, parallel the Alabama High School Physical form in their thorough evaluation of an individual's physical ability to perform under physically demanding conditions. Both forms include detailed medical histories and physical examinations to assess fitness for the task at hand, whether it be military service or school sports.
Pre-employment Physical Examination forms for public safety positions such as firefighters and police officers share commonalities with the Alabama High School Physical form. They focus on ensuring that the individual has the physical capability and health status to perform potentially strenuous activities safely and effectively, minimizing risk of injury on the job.
Lastly, the Department of Transportation (DOT) Physical Examination forms required for commercial drivers mimic the high school physical form in purpose. They ensure that drivers are physically fit to operate commercial vehicles, focusing on cardiovascular health, vision, and hearing assessments, similar to how the Alabama High School Physical form assesses athletes' physical readiness for sporting endeavors.
Filling out the Alabama High School Physical Form is a crucial step for student-athletes looking to participate in interscholastic sports. Here are essential dos and don'ts to consider during this process:
Adhering to these guidelines will streamline the process of completing the Alabama High School Physical Form, helping ensure that student-athletes are cleared for participation in their sports with minimal delay.
Understanding the Alabama High School Physical Form requires dispelling some misconceptions that have arisen. This form plays a crucial role in ensuring the safety and readiness of high school athletes in Alabama. By examining these misunderstandings, we can better appreciate the form's importance and ensure that students are properly evaluated for athletic participation.
Misconception 1: Any doctor can sign the form. - The form requires a signature from a licensed MD (Medical Doctor) or DO (Doctor of Osteopathy) who is fully qualified to determine the athletic readiness of the student. This means that not all healthcare professionals, such as nurse practitioners or chiropractors, have the authority to approve this form.
Misconception 2: The physical form is only about detecting major health issues. - While identifying significant health concerns is essential, the form also focuses on the overall well-being and specific conditions that could affect a student's athletic performance or increase their risk of injury.
Misconception 3: A physical exam is needed only once during a student's high school career. - The examination is valid for one calendar year. Athletes need to undergo a physical exam annually to ensure they are in good health and capable of participating in sports activities.
Misconception 4: The physical form is just a formality. - This document is a crucial part of safeguarding students' health in athletics. It ensures that participants are physically and medically fit, preventing possible health risks associated with sports activity.
Misconception 5: All sections of the form need to be filled out by the physician. - Some parts of the form are specifically designed to be completed by the student or their guardian. These sections provide valuable health history information that aids the examining physician in their evaluation.
Misconception 6: If a student is cleared with conditions, they cannot participate until those conditions are fully resolved. - Being cleared with conditions often means that the student can participate in sports activities but may need to undergo further evaluation, follow specific medical advice, or complete rehabilitation for certain conditions.
Misconception 7: Only the physical examination section is important. - While the physical examination is critical, the health history section provides essential background information. This information can highlight past injuries, illnesses, or conditions that could influence a student's ability to safely participate in sports.
Misconception 8: Digital submissions of the form are always acceptable. - The acceptance of digital or electronic submission of the physical form depends on the school district's policies. Some districts may require a hard copy with original signatures for their records.
Clarifying these misconceptions ensures that students, parents, and school officials understand the physical form’s requirements and the vital role it plays in high school athletics. It highlights the balance between promoting sports participation and prioritizing student health safety.
Filling out and using the Alabama High School Physical Form is a crucial step for student athletes before they participate in any interscholastic athletics. Here are key takeaways to guide you through the process:
Keeping these points in mind when filling out and submitting the Alabama High School Physical Form will help streamline the process and ensure that student athletes meet all requirements for safe participation in their chosen sports.
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