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PARTICIPATION HISTORY AND PHYSICAL EXAMINATION Name: Birth Date: Today's Date: Address: City: Phone: Zip: Sport: HISTORY Yes 1 a. b. c. d. e. f. g. h. 2. 3. 4 a. b. c. d. 5. 6 a. b. c. d. e. 7. 8.
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How to fill out sportsphysicalform-3-4-2014-1 - chcw:
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Make sure you have all the necessary information available, including personal details, medical history, and emergency contacts.
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Start by filling out the patient information section, which typically includes details such as name, address, phone number, date of birth, and social security number.
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Next, provide details about your primary care physician or medical provider, including their name, address, and contact information.
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In the medical history section, provide information about any past or current medical conditions, surgeries, hospitalizations, medications, allergies, or other relevant health information. Be as thorough as possible to ensure accuracy.
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Consult with your healthcare provider about any specific questions or requirements on the form. They may need to fill out certain sections, such as the physical examination portion, so ensure all necessary fields are completed by the appropriate individuals.
Who needs sportsphysicalform-3-4-2014-1 - chcw:
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Student-athletes: Sports physical forms are typically required for students participating in school sports programs. These forms ensure that students are healthy and physically capable of participating in athletic activities safely.
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Parents or guardians: Parents or guardians are often responsible for completing the necessary paperwork for their children. This includes providing accurate information and signing consent forms.
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Medical professionals or healthcare providers: These forms may also be required to be completed or reviewed by medical professionals, such as primary care physicians or sports medicine specialists. They can assess the student's medical history, perform a physical examination, and provide any necessary recommendations or restrictions based on their findings.
Remember, it is essential to consult with your specific educational institution or sports organization to confirm the exact requirements and guidelines for filling out the sports physical form.
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