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PATIENT NAME: ___
DOB: ___Participation Physical Evaluation History Form
Academic Year 20222023
Section 1: Completed by Student
Section 2: Completed by Healthcare Provider
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How to fill out preparticipation physical evaluation

How to fill out preparticipation physical evaluation
01
Schedule an appointment with a healthcare provider.
02
Bring any required forms or paperwork to the appointment.
03
Provide accurate medical history information.
04
Undergo a physical examination by the healthcare provider.
05
Discuss any concerns or medical conditions with the healthcare provider.
06
Follow any additional instructions provided by the healthcare provider.
Who needs preparticipation physical evaluation?
01
Athletes participating in organized sports programs.
02
Individuals planning to start a new exercise or fitness routine.
03
Individuals with certain medical conditions that may impact their ability to participate in physical activities.
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What is preparticipation physical evaluation?
Preparticipation physical evaluation is a medical examination conducted before participating in sports or physical activities to assess the individual's overall health and fitness.
Who is required to file preparticipation physical evaluation?
Student athletes are typically required to file preparticipation physical evaluation before participating in school sports.
How to fill out preparticipation physical evaluation?
Preparticipation physical evaluation forms are typically filled out by a licensed healthcare provider, such as a physician or nurse practitioner, after conducting a thorough examination.
What is the purpose of preparticipation physical evaluation?
The purpose of preparticipation physical evaluation is to ensure that individuals are healthy enough to safely participate in sports or physical activities, and to identify any underlying medical conditions that may require further evaluation or treatment.
What information must be reported on preparticipation physical evaluation?
Preparticipation physical evaluation forms typically require information such as medical history, current medications, allergies, previous injuries, and family history of medical conditions.
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