Get the free Pre-Participation Examination Form - Illinois High School Association

Rescue Union School District SPORTS PHYSICAL EXAMINATION FORM PART 1 (TO BE COMPLETED BY STUDENT AND PARENT’S OR GUARDIAN) LAST NAME FIRST NAME BIRTHDATE FALL SPORT GRADE WINTER SPORT SPRING SPORT

How to fill out pre-participation examination form

How to fill out a pre-participation examination form:

1. Begin by gathering all necessary documents and information: Make sure you have your personal identification, medical insurance information, and any previous medical records or test results that may be relevant.
2. Read the instructions carefully: Before starting to fill out the form, thoroughly read the instructions provided. This will ensure that you understand what information is required and how to provide it accurately.
3. Start with personal details: Begin by providing your full name, date of birth, address, and contact information. Be sure to double-check for any errors or typographical mistakes.
4. Medical history: Fill out any sections related to your medical history. This may include questions about any chronic conditions, previous injuries, allergies, medications you are currently taking, or any surgeries you have undergone. It is important to be honest and thorough while providing this information.
5. Family medical history: Some pre-participation examination forms may ask for details about your family's medical history. Provide any relevant information you are aware of, such as a history of heart disease, diabetes, or other hereditary conditions.
6. Immunization status: Note down your vaccination history, including the dates and types of vaccinations you have received. This information ensures that your immunizations are up-to-date and may be required for certain activities or organizations.
7. Physical examination: If your form requires a physical examination, make sure to schedule an appointment with a healthcare provider. The form will typically include sections for recording your height, weight, blood pressure, vision, hearing, and overall assessment of your health.
8. Consent and signature: At the end of the form, you may be required to provide your consent for the medical examination and acknowledge that the information provided is accurate to the best of your knowledge. Sign and date the form as instructed.

Who needs pre-participation examination form?

A pre-participation examination form is typically required for individuals participating in sports, athletic activities, or organized programs that involve physical exertion. This may include students participating in school sports teams, athletes in college or professional sports, individuals joining gym or fitness facilities, or participants in recreational activities such as dance classes, martial arts, or outdoor adventure programs.

The purpose of the pre-participation examination form is to assess an individual's overall health, identify any underlying medical conditions or risk factors, and determine if they are physically fit to safely participate in the specific activity or sport. By gathering information about an individual's medical history, current condition, and physical abilities, the form helps ensure the safety and well-being of the participant and may also help identify any necessary modifications or accommodations that need to be made.

For pdfFiller’s FAQs

What is pre-participation examination form?

The pre-participation examination form is a medical form that needs to be completed by individuals before participating in certain activities or sports.

Who is required to file pre-participation examination form?

Individuals who wish to participate in certain activities or sports are required to file the pre-participation examination form.

How to fill out pre-participation examination form?

The pre-participation examination form can be filled out by providing personal and medical information, including any previous injuries or medical conditions.

What is the purpose of pre-participation examination form?

The purpose of the pre-participation examination form is to ensure the individual is physically fit to participate in the activity or sport, and to identify any potential health risks.

What information must be reported on pre-participation examination form?

The pre-participation examination form typically requires information on medical history, current medications, allergies, and contact information for emergency purposes.

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