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? 2012-2013 Participation Physical Evaluation HISTORY FORM (NOTE: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep a copy of this form
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How to fill out 2012-2013 preparticipation physical evaluation

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How to Fill out 2012-2013 Preparticipation Physical Evaluation:

01
Begin by obtaining the necessary form: The 2012-2013 Preparticipation Physical Evaluation form can typically be obtained from your school's athletic department, doctor's office, or downloaded from the internet.
02
Complete the personal information section: Provide your full name, date of birth, address, phone number, and emergency contact information. This ensures that the evaluation is linked to the correct individual and allows for easy contact in case of an emergency.
03
Provide medical history: Fill out the medical history section honestly and thoroughly. This includes information about past injuries, chronic illnesses, surgeries, medications, allergies, and any family history of medical conditions. The information provided helps medical professionals assess your overall health and identify any potential risk factors.
04
Immunization records: Make sure to include details about your immunization history, including the dates of any vaccinations or boosters you have received. This is important for ensuring that you are up to date on any required vaccinations for participating in sports or certain activities.
05
Complete the physical examination section: This section is usually filled out by a licensed healthcare professional, such as a physician or nurse practitioner. They will conduct a comprehensive physical examination, evaluating your general health, vital signs, cardiovascular fitness, musculoskeletal system, and more. The healthcare professional will fill out the relevant information, including measurements, observations, and any necessary recommendations or restrictions.
06
Provide consent and signature: Once all the required sections of the form are completed, review it carefully to ensure accuracy. Then, you or your parent/legal guardian (if you are a minor) should sign and date the document, indicating consent and agreement to the information provided.

Who needs 2012-2013 Preparticipation Physical Evaluation?

01
Student-athletes: Any student participating in organized sports or physical activities within a school or community setting may be required to undergo a preparticipation physical evaluation. This includes middle school, high school, and college athletes.
02
Recreational participants: Individuals involved in recreational sports leagues, fitness programs, or other physical activities may also be required to complete a preparticipation physical evaluation. This ensures that participants are in good health and minimizes the risk of injuries during physical activities.
03
Individuals with medical conditions: Those with pre-existing medical conditions, such as asthma, diabetes, or heart conditions, may be asked to undergo a preparticipation physical evaluation to determine their ability to safely participate in physical activities. This evaluation allows healthcare professionals to assess the individual's health status and provide appropriate recommendations or modifications if necessary.
Note: The specific requirements for the 2012-2013 Preparticipation Physical Evaluation may vary between organizations, schools, or states. It is essential to check with the relevant authorities for accurate information and any additional documentation that may be required.
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Preparticipation physical evaluation history is a form completed by an individual's healthcare provider that documents the individual's medical history and physical examination findings.
Athletes participating in organized sports programs are typically required to file preparticipation physical evaluation history.
Preparticipation physical evaluation history is filled out by a healthcare provider during a physical examination. The provider will document the individual's medical history, vital signs, and any relevant physical examination findings.
The purpose of preparticipation physical evaluation history is to assess an individual's overall health and fitness for participation in sports, identify any existing medical conditions or injuries that may affect their ability to safely participate, and determine if any additional testing or precautions are needed.
Information reported on preparticipation physical evaluation history typically includes medical history, current medications, allergies, past injuries, family history of medical conditions, vital signs, and results of the physical examination.
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