Get the free PIAA CIPPE FORM SECTIONS 1 2 3 4 5 6 7 8 and 9 - July 26 2012doc - wayswimming

NORTH CAROLINA HIGH SCHOOL ATHLETIC ASSOCIATION. SPORT ... This is a screening examination for participation in sports. This does not substitute for ...

How to fill out piaa cippe form sections

How to Fill Out PIAA CIPPE Form Sections:

Section 1: Personal Information

1. Start by providing your full name, address, phone number, and date of birth.
2. Include your gender, grade level, and any relevant medical history.
3. Fill out emergency contact details, including the name, phone number, and relationship of each contact person.

Section 2: Insurance Information

1. Indicate the type of insurance coverage you have, whether it's private insurance, Medicaid, or another form of coverage.
2. Provide the insurance company's name, policy number, and any relevant details needed for claims.
3. If you don't have insurance coverage, make sure to note it on the form.

Section 3: Health History

1. Document any known pre-existing medical conditions or injuries that may affect your sports participation.
2. Provide details about any surgeries, hospitalizations, or significant illnesses you have had in the past.
3. Include information about any medications you are currently taking, including dosage and frequency.

Section 4: Medical Evaluation

1. Schedule a visit with a healthcare professional to complete this section. They will assess your overall health and fitness for participating in sports.
2. The healthcare provider should fill out the physical examination portion, which includes vital signs, vision, and any recommendations or restrictions.
3. The medical evaluation should also include a date and signature from the healthcare provider.

Section 5: Parental Consent

1. If you are a minor, this section requires a parent or legal guardian's signature and date.
2. Parents need to acknowledge that they understand the risks associated with sports participation and give consent for their child to participate.
3. Make sure all necessary contact information is provided for parents or guardians to reach in case of an emergency.

Who Needs PIAA CIPPE Form Sections?

1. Student-athletes participating in Pennsylvania Interscholastic Athletic Association (PIAA) sports programs need to complete these form sections.
2. It is required for both middle and high school athletes.
3. These form sections ensure that students are physically fit to participate in sports activities and allow healthcare professionals to provide appropriate medical care if needed.

For pdfFiller’s FAQs

What is piaa cippe form sections?

The PIAA CIPPE form sections refer to the required sections of the Pennsylvania Interscholastic Athletic Association Comprehensive Initial Pre-Participation Evaluation form.

Who is required to file piaa cippe form sections?

Student athletes participating in interscholastic sports in Pennsylvania are required to have the PIAA CIPPE form completed.

How to fill out piaa cippe form sections?

The PIAA CIPPE form sections must be completed by a licensed medical professional such as a physician, physician assistant, or nurse practitioner.

What is the purpose of piaa cippe form sections?

The purpose of the PIAA CIPPE form sections is to ensure that student athletes are healthy and fit to participate in sports activities.

What information must be reported on piaa cippe form sections?

The PIAA CIPPE form sections require information such as medical history, physical examination results, and clearance for participation.

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