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TSSAM PARTICIPATION MEDICAL EVALUATION FORM Name DOB Address City State Zip Home Phone Cell Phone SS# Fathers Name Home # Work # Mothers Name Home # Work # Other Emergency Contact Phone # Relation
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How to fill out tssaa preparticipation medical evaluation

How to fill out TSSAA preparticipation medical evaluation:
01
Obtain the necessary forms: The TSSAA preparticipation medical evaluation forms can usually be found on the official TSSAA website or requested from your school or sports organization.
02
Gather relevant personal information: Fill in your name, date of birth, gender, address, phone number, and emergency contact information in the designated sections of the form.
03
Provide medical history: Answer questions regarding any past or present medical conditions, surgeries, illnesses, or injuries. This information is essential for the healthcare provider to assess your eligibility and provide appropriate care during sports activities.
04
Immunization records: Ensure your immunization records are up to date. Include details of vaccinations received, such as tetanus, meningitis, and seasonal flu shots. These records are needed to protect you and others from contagious diseases.
05
Medication information: Disclose any current medications you are taking, including dosage and frequency. This information will help the healthcare provider understand any potential side effects or interactions with athletic activities.
06
Allergies: Indicate any known allergies, whether to medications, foods, insects, or environmental factors. This will allow the healthcare provider to take necessary precautions and provide appropriate treatment if needed.
07
Family medical history: Provide relevant information about your family's medical history, including conditions such as heart disease, diabetes, asthma, or allergies. This information may help identify potential risks or hereditary conditions affecting your sports participation.
08
Physical examination: Schedule an appointment with a healthcare provider who can conduct a thorough physical examination as part of the preparticipation evaluation. This examination will assess your general health, including your cardiovascular, musculoskeletal, and respiratory systems.
09
Signature and consent: Read through the entire form carefully and sign the necessary consent sections, acknowledging that you have provided accurate information and understand the risks involved in participating in sports activities.
10
Return the completed form: After filling out the form and ensuring all required sections are completed, return it to the appropriate personnel or organization, such as your school's athletic department or your sports coach.
Who needs TSSAA preparticipation medical evaluation?
01
Student-athletes: Any student who wishes to participate in TSSAA-sanctioned sports activities should undergo the preparticipation medical evaluation. This evaluation ensures that student-athletes are physically capable of safely participating in sports and helps identify any potential health risks.
02
Coaches and administrators: Coaches and administrators are responsible for ensuring that all student-athletes have completed the necessary preparticipation medical evaluation forms before participating in TSSAA-sanctioned sports. They play a crucial role in promoting the safety and well-being of student-athletes.
Note: It is important to consult the official TSSAA guidelines and regulations for specific requirements and any updates regarding the preparticipation medical evaluation process.
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