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Stcc.edu/healthservices This form is required only for students in the School of Health Nursing and Early Childhood Education. Student athletes need to complete the Athletic Preparticipation Evaluation. NAME please print ID last DOB first Pulse Date of Exam General HEENT Corrected yes/no Vision Ears Nose Mouth/ teeth B/P Temp Height Abnormal Findings Neck Thyroid CV Heart Pulmonary Lungs Recommendations/ Restrictions Breasts Abdomen Neuro Spine Extremities Strength ROM Neuro/DTR s Pelvic exam...
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