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Department of Athletics Sports Medicine 715 North Avenue New Rochelle, NY 10801 Participation Physical Examination TO BE COMPLETED BY A PHYSICIAN

How to fill out pre-participation physical examination

How to fill out a pre-participation physical examination:

1. Obtain the necessary forms: Contact the organization or institution requiring the physical examination to obtain the required forms. These forms usually include personal information, medical history, and consent for medical evaluations.
2. Provide accurate personal information: Fill out the forms with your personal information, such as name, contact information, date of birth, and any other details requested. Make sure to write legibly and provide accurate information.
3. Complete the medical history section: Answer all the questions regarding your medical history honestly and thoroughly. This may include questions about past illnesses, surgeries, allergies, medications, and any current or previous medical conditions.
4. Include family medical history: Some forms may require information about your family's medical history, including conditions such as heart disease, diabetes, or certain genetic disorders. Answer these questions to the best of your knowledge.
5. Record immunizations: In this section, list all the vaccinations you have received and specify the dates. Immunizations commonly requested include those for tetanus, measles, mumps, rubella, hepatitis, and varicella.
6. Provide details on any current medications: If you are currently taking any medications, write down their names, dosages, and the frequency at which you take them. This information will help the healthcare provider assess your overall health.
7. Add emergency contact information: Include the contact information for a person who can be reached in case of an emergency during the physical examination, such as a family member or close friend.
8. Consent to medical evaluations: Read and understand the consent section, which allows the healthcare provider to conduct necessary medical evaluations and examinations. The forms may also require obtaining parental/guardian consent for minors.
9. Sign and date the forms: Once you have filled out the entire pre-participation physical examination form, sign and date it to indicate your consent and completion.

Who needs pre-participation physical examination:

1. Athletes: Pre-participation physical examinations are commonly required for athletes participating in organized sports or competitions. This helps ensure they are physically capable of participating and reduces the risk of injuries.
2. Students: Some educational institutions may require students to undergo a pre-participation physical examination before participating in physical education classes or certain extracurricular activities.
3. Military personnel: Military organizations often mandate pre-participation physical examinations for recruits to assess their fitness levels and overall health before joining the armed forces.
4. Employees in physically demanding professions: Certain jobs, such as those in law enforcement, firefighting, or construction, may require employees to undergo a pre-participation physical examination to ensure they can perform the essential physical tasks of the job.
5. Individuals undertaking medical treatments: People undergoing certain medical treatments or surgeries may need a pre-participation physical examination to assess their fitness for the specific procedure and reduce potential risks.

It is important to note that the specific requirements for a pre-participation physical examination may vary depending on the organization, institution, or country. It is advisable to consult the relevant guidelines or contact the responsible authority for accurate information on who needs to undergo this examination.

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What is pre-participation physical examination?

A pre-participation physical examination is a medical evaluation that assesses the overall health and fitness of an individual before participating in a specific activity or sport.

Who is required to file pre-participation physical examination?

Athletes, students, and participants in organized sports or activities are typically required to file a pre-participation physical examination.

How to fill out pre-participation physical examination?

To fill out a pre-participation physical examination, one must visit a healthcare provider who will conduct the necessary medical tests and assessments.

What is the purpose of pre-participation physical examination?

The purpose of a pre-participation physical examination is to identify any underlying health issues or conditions that may pose a risk during physical activity or sports participation.

What information must be reported on pre-participation physical examination?

A pre-participation physical examination typically includes medical history, physical examination, vital signs, and any required laboratory tests.