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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 a copy of this form in the chart.)
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How to fill out ihsaa preparticipation physical evaluation

How to fill out ihsaa preparticipation physical evaluation:
01
Obtain the necessary forms: Begin by obtaining the ihsaa preparticipation physical evaluation forms. These forms can usually be found on the IHSAA website or from your school's athletic department.
02
Review the instructions: Before starting the evaluation, carefully review the instructions provided on the form. Make sure you understand the requirements and any specific guidelines.
03
Complete personal information: Begin by filling out the personal information section of the form. This includes your full name, date of birth, address, contact information, and emergency contact details. Ensure that all information provided is accurate and up to date.
04
Medical history: Next, complete the medical history section of the form. This involves providing detailed information about any past or current medical conditions, illnesses, injuries, surgeries, or medications. Be as thorough and honest as possible, as this information is important for your safety during athletic activities.
05
Parental consent: If you are under 18 years of age, a parental consent section will be included in the form. Make sure a parent or legal guardian signs and approves your participation in sports and acknowledges the potential risks involved.
06
Insurance information: Provide details of your medical insurance coverage, including the name of the insurance company, policy number, and any other relevant information. It is important to have valid medical insurance in case of any unexpected injuries or emergencies.
07
Physical examination: Arrange for a physical examination with a qualified healthcare professional. The physical examination must be conducted within a specified time frame before the start of your sports season, as indicated on the form. During this examination, the healthcare professional will assess your overall health, check vital signs, evaluate flexibility and strength, and screen for any potential risks or conditions that may affect your participation in athletic activities.
08
Signature: Once all the information on the form is complete, sign and date it to indicate that all the provided information is accurate and truthful to the best of your knowledge.
Who needs ihsaa preparticipation physical evaluation:
01
Student-athletes: Any student wishing to participate in athletic activities sanctioned by the IHSAA, such as interscholastic sports competitions, may be required to undergo the ihsaa preparticipation physical evaluation. This ensures that the student is physically fit and healthy to participate safely in sports.
02
Schools and coaches: Schools and coaches are responsible for ensuring that their student-athletes have completed the necessary preparticipation physical evaluation. This helps to minimize the risk of injuries and provide a safe environment for athletic activities.
03
Parents or guardians: Parents or legal guardians play a vital role in facilitating the completion of the ihsaa preparticipation physical evaluation for their child. They need to provide accurate medical history and consent for their child's participation in sports, prioritizing their child's safety and well-being.
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What is ihsaa preparticipation physical evaluation?
The ihsaa preparticipation physical evaluation is a medical examination required for student-athletes in Indiana to ensure they are physically able to participate in sports activities.
Who is required to file ihsaa preparticipation physical evaluation?
All student-athletes in Indiana are required to file the ihsaa preparticipation physical evaluation before they can participate in school sports.
How to fill out ihsaa preparticipation physical evaluation?
The ihsaa preparticipation physical evaluation form must be completed by a licensed healthcare provider. The form includes sections for medical history, physical examination, and clearance for participation.
What is the purpose of ihsaa preparticipation physical evaluation?
The purpose of the ihsaa preparticipation physical evaluation is to ensure the health and safety of student-athletes by identifying any medical conditions or physical limitations that may affect their ability to participate in sports.
What information must be reported on ihsaa preparticipation physical evaluation?
The ihsaa preparticipation physical evaluation form requires the reporting of medical history, current medications, allergies, previous injuries, and any existing medical conditions.
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