The Alabama High School Athletic Association Preparticipation Physical Evaluation Form, commonly known as the Alabama High School Physical form, serves as a comprehensive health assessment tool designed to ensure that high school athletes are medically and physically fit to engage in sports activities. This form requires detailed health history and a physical examination, vetted by a medical professional, to discern the athletic readiness of students spanning grades 7 through 12. To ensure your student-athlete meets the required health standards for interscholastic athletics, fill out the form by clicking the button below.
Ensuring the health and safety of high school athletes is a priority that necessitates a comprehensive understanding and completion of the Alabama High School Athletic Association Preparticipation Physical Evaluation Form. This detailed document serves not only as a prerequisite for student participation in interscholastic athletics but also as a critical tool for assessing their physical readiness and identifying any potential risks that participation in sports might pose. From capturing basic information such as the student's name, age, and school, to a thorough medical history that probes into past injuries, ongoing health issues, and any medical conditions that could affect the student's ability to engage safely in sports, the form covers a broad spectrum. It extends further to include a physical examination section, which evaluates the athlete's current health status across various parameters—cardiovascular health, musculoskeletal condition, vision, and more. Additionally, the form adheres to the AHSAA rule requiring a physician's certification of the student's capability to partake in athletic activities, a certification that remains valid for one year from the date of examination. This measure highlights the form's role in not only safeguarding the students' well-being but also in ensuring their ongoing eligibility and readiness for the competitive spirit of high school sports.
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.)
Before participating in high school sports, athletes in Alabama are required to complete a Preparticipation Physical Evaluation Form. This crucial step ensures the safety and readiness of students to engage in athletic activities. To simplify the process, follow the outlined steps below carefully to fill out the Alabama High School Athletic Association's form accurately.
It's imperative to accurately and thoroughly complete each section to maintain the safety and eligibility of the student athlete. Duplicate the form if necessary and remember to keep copies for your records. Upon completion, submit the form to the required school official to ensure the student is cleared for participation in interscholastic athletics.
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 serves two main purposes. First, it ensures that students are physically able to participate in interscholastic athletics safely. This protects the students from potentially life-threatening situations if they have undiagnosed conditions that could be aggravated by strenuous physical activity. Second, it helps schools maintain a record of their athletes' health status, complying with state regulations that mandate a current physical exam for participation in sports. Essentially, this form is a critical step in fostering a secure environment for student-athletes.
Who is required to complete this form?
All students in grades 7-12 who wish to participate in interscholastic athletics within Alabama must have this form completed. It requires input from the athlete and a guardian to attest to the athlete's health history and a thorough examination by a licensed physician, M.D. or D.O. This comprehensive approach ensures that any medical concerns are identified and evaluated before the student engages in sports, thereby minimizing health risks during play.
How often must the physical evaluation be conducted?
The physical evaluation must be conducted once every calendar year. This requirement ensures that any changes in the student’s health status are noted and addressed promptly, thus maintaining the student's eligibility to participate in sports. The form must be updated with a new examination date annually and kept on file at the school as part of the student’s athletic participation records.
What happens if a student is not cleared for participation?
If upon evaluation, a student is not cleared for participation, the examination form will indicate the specific type or level of activity (if any) that the student can safely engage in. This could range from non-contact sports to moderate activities, depending on the physician's assessment of the student's health. It may also include recommendations for follow-up evaluations, rehabilitation, or further medical assessment before the student can be cleared for full participation. Schools and coaches are then responsible for adhering to these recommendations to ensure the well-being of the athlete.
When filling out the Alabama High School Physical form, people often make several mistakes, which can lead to complications or delays in the submission process. It's important to approach this task attentively to ensure all the required information is accurately provided. Here are four common errors:
Not answering all the questions in the history section accurately - The form requires detailed information about the student's medical history, including past injuries, conditions, and any medication being taken. Sometimes, individuals might skip over questions they deem irrelevant or are unsure about, rather than seeking clarification.
Failing to explain "Yes" answers in the specified area - For any question answered with a "Yes," there is a requirement to provide details in the space provided below the question. This part is often overlooked or not filled out thoroughly, leading to incomplete medical information.
Inaccurate or incomplete signatures - The form requires the signatures of both the athlete and a parent or guardian. These signatures must be dated accurately. It's not uncommon for people to either forget to sign, miss one of the required signatures, or not date the signatures, all of which can invalidate the form.
Overlooking the physician’s clearance section - After the physical examination, the examining physician is required to indicate the athlete's clearance status. This section can sometimes be left incomplete, either through oversight or by assuming that a verbal confirmation of fitness suffices. This official clearance is crucial for eligibility.
Being mindful of these common mistakes can help ensure the form is filled out correctly and completely, streamlining the process for students, parents, and school administrators alike.
The Alabama High School Athletic Association Preparticipation Physical Evaluation Form is a vital document for student-athletes, ensuring they are medically and physically prepared for the challenges of high school sports. To complement this evaluation, there are several other forms and documents that are often used to provide a comprehensive overview of the student's health, eligibility, and readiness for athletic participation. These documents are crucial for the safety and well-being of the student-athlete.
Together, these documents form a safety net around the student-athlete, ensuring they are protected, informed, and consent to participation in high school sports with a clear understanding of the inherent risks and responsibilities. It's essential that these forms are completed in detail, kept up-to-date, and accessible to those who need them, safeguarding the health and safety of every student-athlete.
The College Sports Preparticipation Physical Evaluation Form shares similarities with the Alabama High School Physical form in terms of its purpose and structure. Both forms are designed to evaluate an athlete’s physical readiness to partake in sports and require a detailed medical history and a physical examination by a qualified healthcare provider. They assess cardiovascular health, musculoskeletal condition, and other physical attributes essential for athletic participation.
Employment Physical Examination Forms used by employers for potential job candidates are similar as they also gather comprehensive health information to determine an individual’s capability to perform specific job duties. Like the high school physical form, these employment forms often include sections on medical history, a review of systems, and a physical examination to ensure that an individual's health status meets the job requirements.
The Department of Transportation (DOT) Physical Examination Form required for commercial drivers shares commonalities in terms of ensuring safety through health assessments. It focuses on evaluating aspects such as vision, hearing, blood pressure, and overall physical fitness to safely operate commercial vehicles. The systematic approach to assessing fitness for a particular role is a core similarity with the Alabama High School Physical form.
Annual Physical Examination Forms generally used for routine health check-ups encompass a broad evaluation of an individual’s health, similar to the high school physical form. These forms include sections on personal and family medical history, lifestyle behaviors, and a comprehensive physical examination to detect any health issues early and maintain an individual’s overall well-being.
Scouts and Youth Organization Health Forms bear resemblance as they are designed to ensure children and teens are physically and medically prepared to safely engage in activities and events. These forms typically include a health history, immunization record, and a physical examination section, ensuring that participants do not face undue health risks during their involvement in scouting or youth organization activities.
Filling out the Alabama High School Physical Form is a vital step in ensuring students are safe and healthy enough to participate in athletic activities. To streamline the process and avoid common mistakes, here's a guide on what to do and what not to do when tackling this task.
What You Should Do
What You Shouldn't Do
Misconceptions about the Alabama High School Physical Form can lead to confusion among students, parents, and even educators. It's important to clarify these misunderstandings to ensure the health and safety of high school athletes. Here are eight common misconceptions:
The physical form is only for male athletes. This is incorrect. The Alabama High School Athletic Association (AHSAA) requires a preparticipation physical evaluation form for all student-athletes, regardless of their gender. The form makes no distinction between male and female athletes, ensuring all are equally evaluated for participation.
A physical exam is valid for any duration past one year as long as the athlete doesn't compete in a new sport. The validity of a physical exam is strictly for one calendar year from the date of the exam. This period doesn't extend even if an athlete isn't participating in a new sport within that time frame.
Any medical practitioner can sign off on the physical examination form. The form must be certified by a licensed physician, either an M.D. (Doctor of Medicine) or a D.O. (Doctor of Osteopathic Medicine). This requirement ensures that athletes receive a standard level of healthcare evaluation.
As long as the student is cleared to participate, the specific findings of the examination aren’t important. Even if a student is cleared, the specific findings can provide important information about the athlete's health and potential need for further evaluation or rehabilitation before participating.
If a student is not cleared for a specific sport, they are disqualified from all sports. The clearance section of the form has categories (e.g., collision, contact, noncontact) that allow physicians to specify for which types of sports a student might not be cleared. This doesn't necessarily disqualify them from participation in all sports.
The history section is optional if the student has had physicals in the past. The history section is a critical part of the preparticipation evaluation, providing valuable information about the student's health background. It must be completed regardless of previous physicals.
Parents or guardians do not need to sign the physical form. The form requires the signature of both the student-athlete and a parent or guardian. This ensures that there is an acknowledgment of the health evaluation and any potential risks associated with participation in sports.
Only the final clearance matters, not the specific details of the examination. While the clearance is crucial, the details of the physical examination, such as vitals and musculoskeletal findings, inform the clearance decision. They might also guide any needed interventions to ensure the athlete's safety and health.
Understanding these aspects of the Alabama High School Physical Form ensures that students, parents, and school officials are well informed about the process, promoting a safer environment for high school sports participation.
Filling out the Alabama High School Physical form is an essential step in ensuring student-athletes are ready and safe to participate in sports. Here are seven key takeaways to make the process smooth and thorough.
Completing the Alabama High School Physical form with thoroughness and attention to detail can directly impact a student athlete’s ability to engage safely in sports. It’s more than paperwork; it’s a foundational part of ensuring the well-being of young athletes as they pursue their sporting ambitions.
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