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Revised 6/2019PREPARTICIPATION PHYSICAL EVALUATIONPHYSICAL EXAMINATION FORM VALID FOR 2 YEARS Name:Date of Birth:Physician Reminders: 1. Consider additional questions on more sensitive issues. Do
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Obtain a pre-participation physical evaluation form.
02
Fill out the personal information section, including your name, date of birth, and contact information.
03
Provide details about your medical history, including any past injuries or surgeries.
04
Answer questions about any current medical conditions or medications you are taking.
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Complete the family medical history section, providing information about any hereditary conditions.
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Sign the form to acknowledge that all the information provided is true and accurate.
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Return the filled-out form to the appropriate organization or healthcare provider.

Who needs pre-participation physical evaluation for?

01
Pre-participation physical evaluation is typically required for individuals who are planning to participate in sports or other physical activities.
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This evaluation ensures that individuals are physically capable of participating safely and helps identify any underlying medical conditions that may need to be addressed.
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This requirement may apply to students participating in school-sponsored sports programs, athletes joining competitive teams, individuals enrolling in fitness programs, or participants in certain job functions that involve physical exertion.
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The specific requirements may vary depending on the organization or institution involved, so it's important to check with the relevant authority to determine if a pre-participation physical evaluation is necessary.
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The pre-participation physical evaluation (PPE) is a comprehensive health assessment conducted to determine an individual's fitness to participate in sports or physical activities, ensuring they do not have medical conditions that could pose a risk during participation.
Typically, student-athletes are required to file a pre-participation physical evaluation before engaging in school-sponsored sports or activities. This requirement often applies to middle school and high school athletes.
To fill out a pre-participation physical evaluation, an individual should complete a form that includes personal information, a medical history questionnaire, and a physical examination by a qualified healthcare provider, who will assess the individual's health and fitness.
The purpose of the pre-participation physical evaluation is to identify any pre-existing medical conditions, assess physical fitness, promote safe participation in sports, and minimize the risk of injury or complications during athletic activities.
The pre-participation physical evaluation must report information such as medical history, current health status, any prior injuries, medications taken, and findings from the physical examination conducted by a healthcare provider.
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