Alabama Sports Physical Form 2021 Details

The Alabama high school physical form is a document that is completed by students before they can participate in sports or any other extracurricular activities. The form is used to verify that the student is physically able to participate in the chosen activity. The physical form must be completed by a doctor and must include specific information about the student's health history. Completing the Alabama high school physical form is an important step in ensuring that students are safe when participating in extracurricular activities.

Below is the data regarding the form you were seeking to complete. It can show you the span of time you will need to finish alabama high school physical form, what fields you will need to fill in and a few additional specific facts.

QuestionAnswer
Form NameAlabama High School Physical Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesalabama high school physical form, alabama high school athletic form, al physical form, alabama athletic association physical form

Form Preview Example

ALABAMA HIGH SCHOOL ATHLETIC ASSOCIATION

Preparticipation Physical Evaluation Form

History

 

 

Name

Sex

Age

Address

 

 

School

 

Grade

AreDoHaveWhenHasyoua[:Jyoudoctorwashaveusepresentlyeverhadyouranytroubleanyeveranybeensprained/strained,hadpassedspecialmedicalfirstongoingskinallergiesrestricted/deniedtakingotherproblemsheattoldhospitalizedmenstrualbreathingheadproblemsoutequipmentormedicalyouany(medicine,duringinjurymusclewithhavemedicationsorperiod?(itching,orproblemsyourdodislocated,conditionssicklecramps?(pads,concussion?spentinjuryafteryourpollens,eyesrashes,cellcoughparticipationexercise?braces,orsince(infectiousnightortrait?pills(likefractured,foods,vision?duringyourstaph,(prescriptionneckDiabetesbeeslasthospital?mononucleosis,rolls,inMRSA,orbrokensports?evaluation?aftermouthotherAsthma)?acne)?oractivity?oroverhadstingingguard,-thediabetes,repeated-counter?eyeinsects)?guards,infectiousswellingetc.or)?diseases,other Explain "Yes"AnkleanswersFinger[JDShoulderKnee[JThighbelow: Hand[]Foot[JShinForearmWristDHip

nNo0[JLIDD [JO[J

3.Explain[JWhenWhatHave"Yes"Headwaseveranswers:[JtheyourhadBacklongestlastsurgery?menstrualtime betweenperiod?your periods last year?

Date

 

_

Date of

birth

_

Phone

 

_

Sport

0

_

 

0n

etc.)?

•..

YesD

D[JILlnL]

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

_

IDUPLICATE AS NEEDEDI

 

 

 

Rev. 2010

FORM 5

Page 1 of 2

 

 

Preparticipation Physical Evaluation

Physical Examination

 

 

 

N

Corrected:L20 /

Abdominal

 

 

 

 

 

 

 

 

 

 

 

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--Cardiovascular--GenitaliaWeight

 

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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 ofthe examining physician (M.D.

or D.O.) the student is fully able to participate in interscholastic athletics (Grade s 7-12). The AHSAA Physicians Certificate (Form 5) must be used. A physical exam will satisfy the

requirement for one calendar year from the date of the exam.

Findings

Clearance:

 

 

 

 

 

A. Cleared

 

 

 

 

 

B. Cleared after completing evaluation/rehabilitation for:

 

 

_

C. Not cleared for:

0 Collision

 

 

 

 

 

O Contact

 

 

 

 

 

O Noncontact

Strenuous

__

Moderately strenuous

Nonstrenuous

Due to:

 

 

 

 

_

Recommendation:

 

 

 

 

_

Name of physician

Date

_

Address

Phone

_

Signature of physician

, M.D. or D.O.

 

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