Get the free Preparticipation Physical Evaluation History Form - wtps.org - archive wtps

Washington Township High School Department of Athletics Student Athlete Physical Information According to New Jersey State Code (N.J.A.C. 6A:16), students must have their sports physicals performed

How to fill out preparticipation physical evaluation history

How to fill out preparticipation physical evaluation history:

1. Obtain the form: Begin by obtaining the preparticipation physical evaluation history form from the appropriate source, such as your school, sports organization, or medical provider.
2. Personal information: At the top of the form, fill in your personal information, including your full name, date of birth, address, phone number, and emergency contact information. Make sure to double-check for accuracy.
3. Medical history: The next section of the form will typically ask about your medical history. Answer each question honestly and accurately. This may include questions about previous illnesses, injuries, surgeries, allergies, medications, and any ongoing medical conditions.
4. Family medical history: Some forms may also require information about your family medical history. This includes any known genetic or hereditary conditions that may run in your family, such as heart disease or diabetes.
5. Immunization record: Ensure that you have your immunization records handy. The form may ask for details about the vaccines you have received, including the dates they were administered.
6. Medications: If you are currently taking any medications, provide the necessary information on the form. Include the name of the medication, dosage, and any specific instructions or precautions.
7. Doctor's information: The form may require you to provide the contact information for your primary care physician or the healthcare provider responsible for conducting the physical evaluation. Include their name, address, and phone number.
8. Participant's signature: Once you have completed all the sections of the form, sign and date it to acknowledge that the information provided is accurate to the best of your knowledge.

Who needs preparticipation physical evaluation history?

1. Student-athletes: Preparticipation physical evaluation history forms are commonly required for student-athletes who participate in school sports. It ensures that they are physically fit to safely engage in rigorous physical activities.
2. Amateur athletes: Amateur athletes involved in organized sports or competitions may also be required to submit preparticipation physical evaluation history forms. This helps to assess their overall health and identify any potential medical risks.
3. Individuals joining fitness programs: Some fitness programs or organizations may request preparticipation physical evaluation history forms to ensure that individuals are physically capable of participating in their activities safely.
4. Military recruits: Military recruits often need to undergo preparticipation physical evaluations to determine their physical fitness and suitability for service. These evaluations help identify any existing medical conditions and potential risks.
5. Individuals seeking employment in physically demanding jobs: Certain job positions, such as firefighters, police officers, and construction workers, may require preparticipation physical evaluation history forms to assess an individual's physical abilities and identify any potential health risks that could impact job performance.

Note: The specific requirements for preparticipation physical evaluation history may vary depending on the organization or institution. It is always important to check the specific guidelines provided by the relevant authority to ensure compliance.

For pdfFiller’s FAQs

What is preparticipation physical evaluation history?

Preparticipation physical evaluation history is a medical form filled out by an individual prior to participating in a sports or athletic activity.

Who is required to file preparticipation physical evaluation history?

Athletes are required to file preparticipation physical evaluation history before participating in sports or athletic activities.

How to fill out preparticipation physical evaluation history?

To fill out the form, the individual must provide information about their medical history, current health status, and any medication they may be taking.

What is the purpose of preparticipation physical evaluation history?

The purpose of preparticipation physical evaluation history is to ensure that the individual is healthy and fit to participate in the sports or athletic activity.

What information must be reported on preparticipation physical evaluation history?

The form typically requires information about medical conditions, allergies, medications, past injuries, and family medical history.

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