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Annual Intake Form PATIENT INFORMATION First Name___ MI___ Last Name___ Birth Date___ Sex ___ Height ___Weight ___Home Phone_(___)___ Mobile Phone_(___)___ Address___ Email___ Employer/Occupation
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Obtain a copy of the 24-25-jcbd-m-dcps-athletic-physical-form-may-2024.
02
Fill out your personal information including name, address, date of birth, and emergency contact information.
03
Provide information about your medical history, including any pre-existing conditions or medications you are currently taking.
04
Complete the section on immunizations, ensuring that all required vaccines are up to date.
05
Have a parent or guardian sign the form if you are under 18 years old.
06
Schedule a physical examination with a healthcare provider and have them complete the remainder of the form, including any recommendations or restrictions for participation in athletics.
07
Submit the completed form to the appropriate school or athletic department before the specified deadline.

Who needs 24-25-jcbd-m-dcps-athletic-physical-form-may-2024?

01
Student-athletes participating in sports or other organized athletic activities within the DC Public School system.
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The 24-25-jcbd-m-dcps-athletic-physical-form-may is a specific form required by the DC Public Schools for student-athletes to ensure they are medically cleared to participate in sports activities.
All student-athletes participating in DC Public Schools athletics are required to file the 24-25-jcbd-m-dcps-athletic-physical-form-may, including both new and returning athletes.
To fill out the form, students must provide accurate personal information, medical history, and have a healthcare provider complete the medical examination section, ensuring all required signatures are included.
The purpose of the form is to ensure the health and safety of student-athletes by confirming they are physically capable of participating in sports and to collect necessary medical information.
The information that must be reported includes the athlete's personal details, medical history, allergy information, and a physical examination completed by a licensed medical professional.
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