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Authorization for Release
Of Protected Health Information
For Athletic Participation
Physical Exams
Athletes Name___Date of Birth___/___/___Grade___ Age___Address___Sport(s) ___I, ___(printed name
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How to fill out for athletic pre-participation

How to fill out for athletic pre-participation
01
Obtain the pre-participation form from the school or organization.
02
Fill out personal information such as name, date of birth, address, and emergency contact.
03
Provide medical history including any current medical conditions, allergies, and medications being taken.
04
Complete the insurance information section.
05
Have a physician review and sign the form certifying that the individual is physically cleared to participate in athletic activities.
Who needs for athletic pre-participation?
01
Athletes who wish to participate in organized sports or physical activities.
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What is for athletic pre-participation?
Athletic pre-participation refers to the process of completing necessary forms and evaluations before participating in sports activities.
Who is required to file for athletic pre-participation?
Athletes who plan to participate in sports activities are required to file for athletic pre-participation.
How to fill out for athletic pre-participation?
Athletic pre-participation forms can typically be filled out online or through paper forms provided by the school or sports organization.
What is the purpose of for athletic pre-participation?
The purpose of athletic pre-participation is to ensure that athletes are healthy and physically fit to participate in sports activities safely.
What information must be reported on for athletic pre-participation?
Information such as medical history, current medications, allergies, and contact information for emergency purposes must be reported on athletic pre-participation forms.
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