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201112
PRE.PARTICIPATION PHYSICAL EVALUATION
HISTORY FORM
(Note: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep this form in the
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How to fill out preparticipation physical evaluation 2011-12

How to fill out preparticipation physical evaluation 2011-12:
01
Obtain the necessary forms: Contact your school or sports organization to obtain the preparticipation physical evaluation form for the 2011-12 season. This form may also be available online for download.
02
Provide personal information: Fill out the top section of the form, which typically includes fields for your name, address, date of birth, emergency contact information, and insurance details.
03
Medical history: Fill in the section dedicated to your medical history. Provide accurate information about any previous or current medical conditions, surgeries, injuries, allergies, medications, and family medical history.
04
Immunization records: Check the form for any fields related to immunizations. Ensure you have up-to-date records of your immunizations and write down the necessary information in the designated spaces.
05
Physical examination: Schedule an appointment with a healthcare professional who can perform the physical examination required for the preparticipation evaluation. Bring the form with you to the appointment, where the healthcare professional will conduct the examination and fill out the corresponding sections of the form, including vital signs, measurements, and any specific evaluations related to your sport.
06
Review and signature: Once all the necessary information has been completed, carefully review the entire form to ensure accuracy and completeness. Make sure all required sections have been filled out correctly.
07
Parent/guardian consent: If you are a minor, have your parent or guardian review and sign the consent section of the form. This indicates that they approve of your participation in the physical evaluation and any related activities.
08
Submit the form: Return the completed form to the appropriate party, whether it is your school, sports organization, or healthcare provider. Follow any specific instructions provided by the organization regarding submission deadlines and required copies.
Who needs preparticipation physical evaluation 2011-12?
01
Athletes: Preparticipation physical evaluations are typically required for athletes participating in organized sports, especially in school or league settings. It helps ensure that individuals are in good health and physically capable of participating in the chosen sport.
02
Students: Some schools may require all students, regardless of participation in athletics, to complete a preparticipation physical evaluation form as part of their overall health assessment.
03
Sports organizations: Sports organizations may also require athletes to undergo a preparticipation physical evaluation to reduce the risk of injuries and ensure the overall well-being of their participants.
Preparticipation physical evaluations are primarily aimed at ensuring participants are physically fit and healthy to engage in sports activities, minimizing the risk of potential medical complications or injuries.
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What is preparticipation physical evaluation 12?
Preparticipation physical evaluation 12 is a medical evaluation that assesses an individual's health and physical readiness to participate in a specific activity or sport.
Who is required to file preparticipation physical evaluation 12?
Athletes or participants in sports or activities that require a preparticipation physical evaluation are required to file PPE 12.
How to fill out preparticipation physical evaluation 12?
To fill out preparticipation physical evaluation 12, individuals need to provide personal information, medical history, undergo a physical examination, and get clearance from a healthcare provider.
What is the purpose of preparticipation physical evaluation 12?
The purpose of preparticipation physical evaluation 12 is to ensure that individuals are healthy and physically fit to safely participate in a specific activity or sport.
What information must be reported on preparticipation physical evaluation 12?
Information such as personal details, medical history, physical examination findings, and clearance status from a healthcare provider must be reported on PPE 12.
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