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CENTRAL ATLANTIC COLLEGIATE CONFERENCEWORKSHEET FOR HARDSHIP WAIVER Sequestrate: StudentAthlete: Institution: Academic Year Affected: Sport: This appeal is made in accordance with NCAA Bylaw 14.2.5.
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01
Obtain the pre-participation physical examination form from the organization or institution requiring it.
02
Read and understand the instructions on the form carefully.
03
Provide personal information such as name, date of birth, and contact details.
04
Fill out the medical history section, providing details of any previous illnesses, injuries, or surgeries.
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Answer questions related to any current medical conditions or medications being taken.
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Complete the family medical history section, including information about any hereditary conditions.
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Fill out the immunization history section, listing all vaccinations received.
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Provide details of any allergies or reactions to medications.
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Answer questions regarding exercise habits, previous sports participation, and current level of physical fitness.
10
If required, sign and date the form to validate the accuracy of the provided information.
11
Submit the completed form to the appropriate organization or institution before the specified deadline.

Who needs pre-participation physical examination?

01
Athletes participating in organized sports leagues or competitions.
02
Students engaging in physical education classes or school sports.
03
Individuals planning to join fitness or recreational programs.
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Individuals applying for certain jobs that require physical fitness.
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Individuals with underlying medical conditions that may affect physical activity.
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Individuals seeking medical clearance for specific physical activities.

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A pre-participation physical examination is a medical assessment performed to evaluate an individual's health and fitness to participate in sports or physical activities, ensuring they have no conditions that could jeopardize their safety.
Typically, students who plan to participate in school sports programs are required to file a pre-participation physical examination.
To fill out a pre-participation physical examination, individuals need to complete a standardized form that usually includes personal health history, family health history, and any current medical conditions, as well as a physician's evaluation.
The purpose of a pre-participation physical examination is to identify any medical conditions that could put an athlete at risk during participation in sports, help manage existing health issues, and ensure that athletes are fit to compete.
The information that must be reported includes medical history, details of any prior injuries, family medical history, and results from the physical examination conducted by a qualified healthcare provider.
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