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This document serves as a pre-participation physical examination form for student-athletes, aimed at assessing medical history, identifying potential health risks, and providing necessary parental consent for participation in sports. It includes sections for personal information, medical history, orthopedic history, and examination results.
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How to fill out pre-participation history physical exam

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How to fill out pre-participation history physical exam

01
Gather all relevant medical history documents and information.
02
Ensure the individual is in a comfortable setting to discuss health concerns.
03
Start with personal information such as name, date of birth, and contact information.
04
Document any past medical conditions, surgeries, or hospitalizations.
05
Record any current medications and allergies.
06
Ask about family medical history to identify any hereditary conditions.
07
Inquire about physical activity levels and any sports participation history.
08
Evaluate any previous injuries, particularly those that may affect participation in sports.
09
Discuss any symptoms such as dizziness, chest pain, or shortness of breath.
10
Complete the exam with a physical assessment including height, weight, blood pressure, and heart rate.

Who needs pre-participation history physical exam?

01
Individuals intending to participate in sports or physical activities.
02
High school and college athletes.
03
Children involved in youth sports programs.
04
Anyone returning to sports after an injury.
05
Individuals undergoing a significant change in physical activity levels.
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A pre-participation history physical exam is a medical assessment conducted to evaluate an individual's fitness to participate in sports or physical activities. It typically includes a review of the individual's medical history, physical examination, and assessment of health risks.
Typically, athletes wishing to participate in school or organized sports are required to file a pre-participation history physical exam. This may include students in middle school, high school, and college sports programs.
To fill out a pre-participation history physical exam, individuals should complete the medical history questionnaire, providing accurate information regarding past illnesses, surgeries, medications, allergies, and any current health issues. It is important to have the form signed by a parent or guardian if the individual is a minor.
The purpose of the pre-participation history physical exam is to identify any potential health issues or risks that could affect an individual's safety and performance during sports or physical activities, ensuring that participants are fit to engage in such activities.
Information that must be reported includes personal medical history, previous injuries, surgeries, medications, current health conditions, allergies, family medical history, and any symptoms that may impact participation in sports.
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