Get the free PHYSICAL EXAMINATION CLEARANCE FORM This form must be on file in the school before p...

PHYSICAL EXAMINATION CLEARANCE From This form must be on file in the school before practicing with any athletic team Student Name: Birth Date: Age: Gender: M / F Address: Home Telephone: School: Grade:

How to fill out physical examination clearance form

How to fill out a physical examination clearance form:

1. Start by carefully reading the instructions provided on the form. Make sure you understand the purpose and requirements of the clearance form.
2. Provide personal information such as your full name, date of birth, address, and contact information. This information helps identify you and ensures proper record-keeping.
3. Fill in any required medical history details. This may include past illnesses, surgeries, or chronic conditions. Be honest and thorough in providing this information as it assists healthcare professionals in assessing your health status.
4. If requested, provide a list of current medications you are taking. Include any prescribed medications, over-the-counter drugs, vitamins, or supplements. Mention dosage and frequency of use for each medication.
5. Answer all the questions related to your lifestyle habits, such as smoking, alcohol consumption, and exercise routine. This helps evaluate your overall health and determine any potential risk factors.
6. If required, provide a urine or blood sample. This may be necessary to test for specific conditions or substances. Follow the instructions provided to collect and submit the sample correctly.
7. Review the completed form for accuracy and completeness. Ensure all sections have been appropriately filled out, and there are no spelling or grammatical errors.
8. If necessary, visit a healthcare professional for a physical examination. This might involve measuring vital signs like blood pressure, heart rate, and height/weight. The healthcare professional will fill out the required sections and sign the form.
9. Submit the completed form as instructed. This may involve delivering it to a specific office or mailing it to the designated recipient.

Who needs a physical examination clearance form:

1. Student athletes: Many schools and colleges require student athletes to undergo a physical examination before participating in athletic activities. The clearance form ensures their safety and helps identify any underlying health concerns.
2. Job applicants: Certain job positions, particularly those involving physically demanding tasks or sensitive environments, may require candidates to undergo a physical examination for clearance. This helps assess their fitness for the role and ensures a safe work environment.
3. Individuals joining certain organizations or programs: Some organizations or programs, such as the military, police departments, or volunteer positions, may require physical examination clearance to ensure the individual is physically capable and fit for the responsibilities involved.

For pdfFiller’s FAQs

What is physical examination clearance form?

A physical examination clearance form is a document that verifies an individual's physical health status and usually needs to be completed by a medical professional.

Who is required to file physical examination clearance form?

Certain individuals such as athletes, students, or employees may be required to file a physical examination clearance form, depending on the policies of the organization or institution.

How to fill out physical examination clearance form?

To fill out a physical examination clearance form, one typically needs to provide personal information, medical history, undergo a physical examination, and have the form reviewed and signed by a medical professional.

What is the purpose of physical examination clearance form?

The purpose of a physical examination clearance form is to ensure that individuals are physically capable of participating in certain activities, programs, or job requirements without posing a risk to themselves or others.

What information must be reported on physical examination clearance form?

The information required on a physical examination clearance form may include personal details, medical history, current health status, and any recommendations or restrictions from the medical professional.

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