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Revised 7/1/05 Mandatory Preparticipation Physical Evaluation HISTORY FORM Date of Exam Name SexAgeDate of birth GradeSchoolSport s AddressPhone Personal Physician In case of emergency contact Explain Yes answers below. Circle questions you don t know the answers to. Yes No 1. Has a doctor ever denied or restricted your participation in sports for any reason 2. Do you have an ongoing medical condition like diabetes or asthma 3. Are you currently taking any prescription or nonprescription...

How to fill out preparticipation physical evaluation

How to fill out preparticipation physical evaluation

1. Gather required paperwork, including the preparticipation physical evaluation form.
2. Schedule an appointment with a healthcare provider, such as a doctor or nurse practitioner.
3. Complete the medical history section on the form, including any previous injuries, surgeries, and medical conditions.
4. Bring a list of current medications and any relevant health records to the appointment.
5. During the appointment, the healthcare provider will conduct a physical examination, checking vital signs, vision, and overall health.
6. Discuss any concerns or questions with the healthcare provider during the evaluation.
7. Obtain the provider's signature on the form if cleared for participation in sports or activities.
8. Submit the completed form to the appropriate sports authority or school official.

Who needs preparticipation physical evaluation?

1. Students participating in school sports.
2. Athletes entering college sports programs.
3. Individuals involved in recreational sports or physical activities.
4. Those returning to sports after an injury.
5. New sports team members in various age groups.

People Also Ask about

What is a pre-participation screening?

The purpose of pre-participation screening in sports is to decrease the number of sport-related injuries and death by identifying individual abnormalities that may predispose an athlete to injury.

What is a preparticipation screening?

Traditionally, pre-participation screenings consisted of a medical examination and a subjective history to identify potential risk factors for further injury such as cardiovascular conditions, asthma, diabetes, etc..

What is the main purpose of pre-exercise screening?

Pre-exercise screening is used to identify people who may have medical conditions which put them at a higher risk of an adverse event# during physical activity/exercise. It is a filter or 'safety net' to help determine if the potential benefits of exercise outweigh the risks for an individual.

What is the purpose of a preparticipation examination?

The goal of the preparticipation physical examination (PPE) is to promote health and safety during competition by screening athletes for injuries and illness. Historically it has been reported that the PPE may be the only medical evaluation that many student athletes receive.

What is the minimum visual acuity for a sports physical?

The required visual acuity for a sports physical can vary depending on the specific sport and organization, but a common standard is 20/40 in both eyes [@\5@].

What is a pre-screening assessment?

A pre-screening interview is used by employers to rule out unqualified candidates before taking the time to formally interview them. This is often in the form of a phone interview and lasts 20-30 minutes. This gives employers a chance to learn an overview of the candidate's work experience and qualifications.

For pdfFiller’s FAQs

What is preparticipation physical evaluation?

Preparticipation physical evaluation (PPE) is a health screening process conducted to assess the readiness of individuals, particularly athletes, to safely participate in sports or physical activities. It typically includes a medical history review and a physical examination.

Who is required to file preparticipation physical evaluation?

Typically, students participating in school sports, athletes entering college athletics, and individuals involved in organized community sports programs are required to file a preparticipation physical evaluation.

How to fill out preparticipation physical evaluation?

To fill out a preparticipation physical evaluation, individuals should complete a medical history form, provide details about any existing health conditions or previous injuries, and undergo a physical examination conducted by a licensed healthcare provider.

What is the purpose of preparticipation physical evaluation?

The purpose of preparticipation physical evaluation is to identify any health concerns or conditions that could pose risks during sports participation, assess physical readiness, and ensure the safety of the individual in physical activities.

What information must be reported on preparticipation physical evaluation?

The information that must be reported on a preparticipation physical evaluation includes personal health history, family health history, previous injuries, current medications, allergies, and results from the physical examination performed by the healthcare provider.