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HEALTH QUESTIONNAIRE
PLEASE PRINT CLEARLY
Last Name: ___First Name: ___
Height: ___Weight: ___DOB: ___Age: ___
Medication Allergies: ___
Medication List (including nonprescription)
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Personal
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How to fill out student-athlete health history form
How to fill out student-athlete health history form
01
Obtain the student-athlete health history form from the school or sports organization.
02
Fill out the form with accurate and up-to-date information about the student-athlete's medical history.
03
Provide details about any past injuries, illnesses, or medical conditions that may affect the student-athlete's participation in sports.
04
Include information about any medications the student-athlete is currently taking.
05
Sign and date the form to certify that the information provided is accurate and complete.
Who needs student-athlete health history form?
01
Student-athletes who participate in school or organized sports programs.
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What is student-athlete health history form?
The student-athlete health history form is a document designed to collect and assess the medical history of student-athletes to ensure their safety and readiness to participate in sports.
Who is required to file student-athlete health history form?
All student-athletes participating in interscholastic or intercollegiate sports are typically required to file a health history form.
How to fill out student-athlete health history form?
To fill out the student-athlete health history form, individuals should provide accurate and complete information regarding their medical history, including past injuries, surgeries, allergies, and current medications.
What is the purpose of student-athlete health history form?
The purpose of the student-athlete health history form is to identify any potential health concerns that could impact the athlete's ability to participate safely in sports.
What information must be reported on student-athlete health history form?
The information that must be reported includes personal medical history, family medical history, any previous injuries, surgeries, current medications, allergies, and any other relevant health information.
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