Fill Out a Valid Alabama High School Physical Form

Fill Out a Valid Alabama High School Physical Form

The Alabama High School Physical form is a critical document designed to assess a student's fitness for participation in interscholastic athletics. It collects essential medical history and evaluation information to ensure that athletes are physically prepared and safe to engage in sports activities. Compliance with this form is mandatory for students in grades 7-12 wishing to compete in Alabama high school athletics.

Access This Alabama High School Physical Now

The Alabama High School Physical form is a crucial document designed to ensure the safety and well-being of student-athletes participating in interscholastic sports. This form requires comprehensive information about the athlete's medical history, including any past injuries, surgeries, or ongoing health issues. Athletes must disclose details such as allergies, respiratory problems, and any medications they are currently taking. Additionally, the form includes a section for a physical examination conducted by a licensed physician, who assesses various health metrics, including cardiovascular health, musculoskeletal condition, and overall physical fitness. A physician’s signature is mandatory, certifying that the athlete is cleared for participation in sports. This evaluation is valid for one calendar year, emphasizing the importance of regular health assessments. Parents or guardians must also sign the form, affirming the accuracy of the information provided. Ultimately, this form serves as a safeguard for both the athletes and the schools, ensuring that students are physically prepared to engage in sports activities safely.

Dos and Don'ts

When completing the Alabama High School Physical form, it is essential to follow certain guidelines to ensure accuracy and compliance. Here are eight recommendations:

  • Do read the entire form carefully before starting.
  • Do provide accurate and complete information regarding medical history.
  • Do ensure that all signatures are obtained from both the athlete and the parent or guardian.
  • Do include the date of the physical exam and the athlete's date of birth.
  • Don't leave any sections blank; all questions must be answered.
  • Don't falsify or omit any medical information, as this can lead to serious consequences.
  • Don't forget to make copies of the completed form for your records.
  • Don't submit the form without confirming that it is signed by a licensed physician.

Following these guidelines will help ensure a smooth process for participating in high school athletics.

Key takeaways

Filling out the Alabama High School Physical form is an essential step for student-athletes. Here are key takeaways to consider:

  • Accurate Information: Ensure all personal details, such as name, age, and school, are filled out correctly.
  • Medical History: Provide a thorough account of any past injuries, medical conditions, or surgeries.
  • Doctor's Signature: A licensed physician must sign the form, certifying that the student is fit for participation.
  • Validity Period: The physical exam is valid for one calendar year from the date of the examination.
  • Eligibility Requirement: The form is required for students in grades 7-12 to participate in interscholastic athletics.
  • Emergency Contact: Include a phone number for emergencies, ensuring quick communication if needed.
  • Specific Sports: Indicate the sports the student intends to participate in, as this may affect the evaluation.
  • Clearance Status: The physician will indicate whether the student is cleared for participation and under what conditions.
  • Rehabilitation Notes: If the student has not been cleared, the form should specify any required evaluations or rehabilitation.
  • Parental Consent: A parent or guardian must sign the form, confirming their awareness and approval of the student's participation.

Completing this form accurately and thoroughly is vital for the health and safety of student-athletes. It ensures they are ready for the physical demands of their chosen sports.

Find Common Documents

Example - Alabama High School Physical Form

ALABAMA HIGH SCHOOL ATHLETIC ASSOCIATION

Revised 2018

Revised 2018

Preparticipation Physical Evaluation Form

 

History

Date_______________________

Name__________________________________________________ Sex ________ Age______ Date of birth _______________

Address ______________________________________________________________________ Phone______________________

School ________________________________________________________Grade __________ Sport ______________________

Explain “Yes” answers below:

 

 

 

 

 

Yes

No

1.

Has a doctor ever restricted/denied your participation in sports?

 

 

 

 

 

2.

Have you ever been hospitalized or spent a night in a hospital?

 

 

 

 

 

 

Have ever had surgery?

 

 

 

 

 

 

 

 

3.

Do you have any ongoing medical conditions (like Diabetes or Asthma)?

 

 

 

 

4.

Are you presently taking any medications or pills (prescription or over‐the‐counter?

 

5.

Do you have any allergies (medicine, pollens, foods, bees or other stinging insects)?

 

6.

Have you ever passed out during or after exercise?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you ever been dizzy during or after exercise?

 

 

 

 

 

 

 

 

Have you ever had chest pain or discomfort in your chest during or after exercise?

 

 

Do you tire more quickly than your friends during exercise?

 

 

 

 

 

 

 

Have you ever had high blood pressure?

 

 

 

 

 

 

 

 

Have you ever been told that you have a heart murmur, high cholesterol, or heart infection?

 

 

Have you ever had racing of your heart or skipped heartbeats?

 

 

 

 

 

 

Has anyone in your family died of heart problems or a sudden death before age 50?

 

 

Does anyone in your family have a heart condition?

 

 

 

 

 

 

 

Has a doctor ever ordered a test on your heart (EKG, echocardiogram)?

 

 

 

 

7.

Do you have any skin problems (itching, rashes, staph, MRSA, acne)?

 

 

 

 

 

8.

Have you ever had a head injury or concussion?

 

 

 

 

 

 

 

 

Have you ever been knocked out or unconscious?

 

 

 

 

 

 

 

 

Have you ever had a seizure?

 

 

 

 

 

 

 

 

 

Have you ever had a stinger, burner, pinched nerve, or loss of feeling or weakness in your arms or legs?

 

9.

Have you ever had heat or muscle cramps?

 

 

 

 

 

 

 

 

Have you ever been dizzy or passed out in the heat?

 

 

 

 

 

 

10. Do you have trouble breathing or do you cough during or after activity?

 

 

 

 

 

Do you take any medications for asthma (for instance, inhalers)?

 

 

 

 

 

11. Do you use any special equipment (pads, braces, neck rolls, mouth guard, eye guards, etc.)?

 

12. Have you had any problems with your eyes or vision?

 

 

 

 

 

 

 

Do you wear glasses or contacts or protective eye wear?

 

 

 

 

 

 

13. Have you had any other medical problems (infectious mononucleosis, diabetes, infectious diseases, etc.)?

 

14. Have you had a medical problem or injury since your last evaluation?

 

 

 

 

 

15. Have you ever been told you have sickle cell trait?

 

 

 

 

 

 

 

 

Has anyone in your family had sickle cell disease or sickle cell trait?

 

 

 

 

 

16. Have you ever sprained/strained, dislocated, fractured, broken or had repeated swelling or other

 

 

injuries of any bones or joints?

 

 

 

 

 

 

 

 

 

Head

Back

Shoulder

Forearm

Hand

Hip

Knee

Ankle

 

 

Neck

Chest

Elbow

Wrist

Finger

Thigh

Shin

Foot

 

17.When was your first menstrual period?__________________________________________________________________

When was your last menstrual period?___________________________________________________________________

What was the longest time between your periods last year?________________________________________________

Explain “Yes” answers:

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

I hereby state that, to the best of my knowledge, my answers to the above questions are correct.

Signature of athlete ___________________________________________________________ Date ___________________

Signature of parent/guardian __________________________________________________

FORM 5

DUPLICATE AS NEEDED

Rev. 2018 (The revised 2018 form is the official form accepted by the AHSAA.)

Page 1 of 2

Preparticipation Physical Evaluation Rule 1, Sec. 14 — In order for a student to be eligible for interscholastic athletics, there must be

on file in the Superintendent’s or Principal’s office a current physician’s statement certifying that

__________________________________________ the student has passed a physical exam, and that in the opinion of the examining physician (M.D.

 

 

 

Student's name

or D.O.) the student is fully able to participate in interscholastic athletics (Grade s 7‐12). The

 

 

 

AHSAA Physicians Certificate (Form 5 Rev. 2018) must be used. A physical exam will satisfy the

 

 

 

 

 

Physical Examination

requirement for one calendar year through the end of the month from the date of the exam. For

example, a physical given on May 5, 2019, will satisfy the requirement through May 31, 2020.

 

 

 

 

 

 

 

 

 

 

Height ____________ Weight _____________ BP _____ / _____ Pulse ____________

 

 

 

 

Vision R 20 / ____ L 20 / ____ Corrected: Y N

Revised 2018

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIMITED

 

Normal

 

 

Abnormal Findings

 

 

 

 

 

 

 

 

 

 

 

Cardiovascular

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pulses

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Heart

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lungs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Skin

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E.N.T.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETE

 

Abdominal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Genitalia (males)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Musculoskeletal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Neck

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shoulder

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Elbow

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wrist

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hand

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Back

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Knee

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ankle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Foot

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clearance:

A.Cleared

B.Cleared after completing evaluation/rehabilitation for: _______________________________________

C. Not cleared for:

Collision

 

 

 

Contact

 

 

 

Noncontact ____ Strenuous

____ Moderately strenuous

____ Nonstrenuous

Due to: ____________________________________________________________________________________________

Recommendation: _________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Name of physician ________________________________________________________________ Date ____________________

Address ________________________________________________________________________ Phone___________________

.

Signature of physician _____________________________________________________________, M.D. or D.O.

(Form must be signed and dated by the attending physician.)

Rev. 2018 (The revised 2018 form is the official form accepted by the AHSAA.)

Misconceptions

  • Misconception 1: The physical form is only required for athletes.
  • This form is necessary for all students participating in interscholastic athletics, regardless of the sport. It ensures that all students are medically cleared to participate.

  • Misconception 2: A physical exam is only valid for one season.
  • A physical exam is valid for one calendar year from the date of the exam. This means that students do not need to get a new physical for each season, as long as it is within that year.

  • Misconception 3: Parents can sign the form without a doctor's approval.
  • Parents must ensure that the physical exam is completed by a licensed physician (M.D. or D.O.). The physician's signature is crucial for the form to be valid.

  • Misconception 4: The form can be filled out by anyone.
  • The form must be completed accurately by the student and their parent or guardian, but it also requires a physician’s assessment. Incorrect or incomplete information can lead to issues with eligibility.

  • Misconception 5: Only certain medical conditions need to be disclosed.
  • All medical conditions, past injuries, and relevant health history should be disclosed on the form. This comprehensive disclosure helps ensure the safety of the student during athletic participation.

  • Misconception 6: The physical evaluation is just a formality.
  • The physical evaluation is a critical step in ensuring the athlete's health and safety. It assesses their ability to participate in sports and identifies any potential risks.

  • Misconception 7: Students can participate in sports without the physical form.
  • Without a completed and signed physical form on file, students are not eligible to participate in any interscholastic athletics. This requirement is strictly enforced to prioritize student safety.

Similar forms

  • Sports Physical Form: Similar to the Alabama High School Physical form, this document is required for student-athletes before participating in sports. It collects information about the athlete's medical history and current health status, ensuring they are fit to compete.
  • College Athlete Medical Clearance Form: This form is used by colleges and universities to confirm that incoming athletes have passed a physical examination. Like the Alabama form, it requires a physician's signature and details about the athlete's health history.
  • Camp Physical Form: Often required for participation in summer sports camps, this document assesses an athlete's health and readiness for physical activity. It shares similarities with the Alabama form in terms of medical history questions and physician evaluations.
  • Workplace Fitness for Duty Form: Employers may use this form to determine if an employee is physically capable of performing job duties. It parallels the Alabama form by requiring a health assessment and may include similar medical history inquiries.
  • Emergency Medical Information Form: This document is filled out by parents or guardians and provides critical health information in case of emergencies. It is similar to the Alabama form in that it collects essential medical history to ensure safety during physical activities.
  • General Health Assessment Form: Used in various settings, this form gathers comprehensive health information about an individual. Like the Alabama High School Physical form, it aims to identify any medical concerns that may affect participation in physical activities.