The Alabama High School Physical form, officially known as the Preparticipation Physical Evaluation Form, is a document used to assess the medical fitness of students wishing to participate in interscholastic athletics. It collects comprehensive health history and details of physical examinations, which are prerequisites for sports participation in grades 7-12 as per Alabama High School Athletic Association (AHSAA) regulations. This form ensures that a student athlete is physically able to engage in sports activities, through a series of medical checks and history evaluations conducted by a physician.
Ensuring the health and safety of student athletes stands as a fundamental priority within the realm of high school sports, a commitment underscored by procedures like the comprehensive Alabama High School Athletic Association's Preparticipation Physical Evaluation. This critical document, revised in 2010, serves as a gatekeeper to participation, insisting on a detailed medical history that captures past health issues, current conditions, and potential risks that might affect a student's ability to engage safely in athletic endeavors. From querying a spectrum of health issues—ranging from allergies, heart problems, to prior injuries, and even specific episodes like concussions—the form seeks to paint a complete picture of the student's health profile. The Physical Examination section complements the historical data with current health metrics like blood pressure, heart rate, and an assessment of musculoskeletal integrity, ensuring a thorough review is conducted by a qualified physician. Moreover, the form mandates explicit parental involvement and acknowledgment, bolstering the safeguarding process. To be deemed eligible for interscholastic athletics, students must secure a clearance which is meticulously documented on the form, tagging each athlete with one of three clearance levels tailored to their condition after the assessment. This rigorous process underscores the Alabama High School Athletic Association's unyielding dedication to fostering a safe, healthy, and inclusive sporting environment for all student athletes.
ALABAMA HIGH SCHOOL ATHLETIC ASSOCIATION
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
LIMITED
Normal
Abnormal Findings
Cardiovascular
Pulses
Heart
Lungs
Skin
E.N.T.
COMPLETE
Abdominal
Genitalia (males)
Musculoskeletal
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.)
Before participating in high school athletics, it's essential for students in Alabama to complete the Preparticipation Physical Evaluation Form correctly. This form is a crucial step to ensure athletes are in good health and capable of engaging in sports activities. It involves providing detailed personal and medical history, followed by a thorough physical examination conducted by a healthcare professional. Below are the steps needed to fill out this form accurately to ensure a smooth process.
Once completed, this form must be submitted to the appropriate school official to be kept on file. This will fulfill the Alabama High School Athletic Association’s requirement for student athletes’ participation in sports, confirming they are medically eligible for the academic year.
The purpose of the Alabama High School Physical Form, officially designated as the Preparticipation Physical Evaluation Form, is to ensure that students are medically and physically fit to engage in interscholastic athletics. It necessitates a thorough physical examination by a qualified healthcare provider, ensuring the student's safety during athletic activities and compliance with the Alabama High School Athletic Association (AHSAA) regulations.
Any student in grades 7-12 seeking to participate in interscholastic athletics within schools governed by the AHSAA must complete the form. This document must be on file in either the Superintendent's or Principal's office before the student's participation.
The form encompasses a detailed history section where students must disclose past medical history, current health concerns, medications, and any history of injuries or conditions that may affect their participation in sports. Additionally, the Physical Examination section requires a healthcare provider's findings on the student's general health, including cardiovascular, musculoskeletal, and other systems assessments. The form also captures the student's and parent/guardian's signatures, affirming the accuracy of the provided information.
The examination must be completed by a licensed physician (M.D. or D.O.). This ensures that the student's physical fitness is assessed by a professional capable of determining their ability to participate in athletic activities safely.
The physical exam is valid for one calendar year from the date of the examination. Students must undergo a new physical examination annually to maintain eligibility for interscholastic sports participation.
If a student is not cleared for participation, the examining physician will indicate the reasons and any recommended evaluations, treatments, or rehabilitation necessary before participation. The clearance status may be categorized as either cleared, cleared after additional evaluation/rehabilitation, or not cleared, with specifics regarding the type of sports participation deemed inappropriate. This ensures a focus on the student's well-being and safety.
The completed and signed Alabama High School Physical Form must be filed in the Superintendent's or Principal's office of the student's school. Keeping this form on file ensures that the school has a record of the student's medical fitness to participate in sports, as mandated by AHSAA regulations.
Filling out the Alabama High School Physical form requires attention to detail and honesty, but mistakes can happen. One common error is not providing complete contact information, such as leaving out a phone number or address. This might seem minor, but it's crucial for communication, especially if follow-up is needed.
Another mistake is inaccurately reporting medical history. This section is vital as it informs the medical professional about past injuries or conditions that could affect the student’s participation in sports. Sometimes, there's a tendency to forget or minimize past issues, but this can lead to severe health risks.
Many also overlook the importance of the medication list. Not listing all medications, including over-the-counter ones, can result in harmful drug interactions or affect the student's ability to safely engage in sports. Each medication has a potential impact on physical performance and well-being.
Not fully explaining "Yes" answers is another common mistake. When a question is answered with a "Yes," details are needed to understand the context and severity of the issue. Without explanation, those reviewing the form may not have enough information to accurately assess the student’s health status.
Skipping questions or sections, possibly because they seem irrelevant or due to oversight, is a mistake. Each question is designed to gather necessary information. Leaving gaps forces those reviewing the form to make assumptions, which could be incorrect.
Ignoring the requirement for signatures is a critical error. Both the athlete and a parent or guardian must sign the form. Without these signatures, the form is incomplete and cannot be processed, potentially delaying the student's participation in sports activities.
Some misunderstand the period of validity for the physical exam. The exam is only good for one calendar year from the date it was performed. Misunderstanding this could lead to a student participating without a current physical, violating school policy, and potentially endangering their health.
Another mistake is not using the AHSAA Physician’s Certificate (Form 5) as required. This specific form is necessary for the physical to be recognized and meet eligibility requirements for interscholastic athletics. Using a different form could result in the student's ineligibility.
Finally, a common error is not updating the physical form when a student's health condition changes after the initial submission. Any new diagnoses, injuries, or changes in medication should be communicated to ensure the student's health records are current and that they are participating safely in sports activities.
When preparing for participation in high school athletics in Alabama, the Preparticipation Physical Evaluation Form is a crucial starting point for ensuring student-athletes meet the necessary health requirements. However, this represents just one component of a broader assortment of documentation often required for a comprehensive assessment of a student’s readiness and eligibility for athletic endeavors. The following documents typically accompany the Alabama High School Physical form, each serving a unique but complementary role in the process.
Together, these documents create a comprehensive portfolio that addresses the health, safety, academic, and behavioral standards necessary for student-athletes. While the primary focus may initially be on the physical condition of the student through the Preparticipation Physical Evaluation Form, the additional forms ensure a holistic approach to student participation in school athletics, setting clear expectations and safeguards for all involved.
The Alabama High School Physical form is a crucial document for student-athletes, ensuring they're fit to participate in sports. Its format and the type of information it gathers share similarities with various other documents across different fields. Understanding these resemblances can shed light on the broad applicability of health and safety protocols in both educational and professional environments.
College Health Forms: Similar to the high school physical form, college health forms assess the overall health and vaccination status of students to ensure their safety and the safety of others on campus. Both documents often require information on past medical history, immunizations, and a physical examination.
Employment Physical Examination Forms: Before starting a new job, especially one that is physically demanding, you may be required to undergo a physical examination. This is similar to the high school physical, ensuring that the individual is capable of performing the job duties without risking their health.
Sports Club Membership Forms: Sports clubs also necessitate a form of physical evaluation to make sure members can safely engage in activities. These forms, like the high school physical form, often inquire about medical history and current physical fitness levels.
Driver’s Medical Evaluation Forms: In certain cases, particularly for commercial drivers, a medical evaluation is required to ensure the driver can safely operate a vehicle. These forms assess similar health metrics and physical abilities as the high school physical form.
Preoperative Assessment Forms: Before undergoing surgery, patients fill out preoperative assessment forms that evaluate their health status, similar to how the high school physical form assesses a student's ability to participate in sports. Both forms help in identifying any potential risks to the individual's health.
Annual Check-Up Forms: When visiting a doctor for an annual health check-up, patients often complete a form that reviews their health history, medications, and current health concerns, akin to the high school physical form's thoroughness in evaluating health for sports participation.
Volunteer Application Forms for Physical Work: Some volunteer positions, especially those involving physical labor, require candidates to complete health forms similar to the high school physical to ensure they're fit for the activity.
Travel Health Forms: For international travel, especially to locations with health risks, travelers may need to complete health forms that assess their fitness to travel and exposure to contagious diseases, much like the preventive nature of the high school physical.
Medical Clearance Forms for Recreational Activities: Activities like diving or high-altitude hiking often require medical clearance forms that ensure participants are physically capable of safely engaging in these strenuous activities, similar to the intent behind the high school physical.
Personal Training Health Questionnaire: Before starting a new personal training regimen, fitness centers usually require a health questionnaire to tailor the program to the individual's physical capabilities and health concerns, much like the individualized safety approach of the high school physical form.
These documents, while tailored to specific contexts, universally aim to ensure the safety and well-being of individuals engaging in various activities. The Alabama High School Physical form serves as an important example of preventive health measures at the intersection of education, athletics, and community health.
When preparing to fill out the Alabama High School Physical Form, it's crucial to remember specific dos and don'ts to ensure the process is smooth and the information provided is accurate. This serves not only as a compliance measure with the Alabama High School Athletic Association but also as a means to guarantee the safety and welfare of student-athletes.
Things You Should Do:
Things You Shouldn't Do:
There are several misconceptions about the Alabama High School Physical Form that can lead to confusion among parents, students, and school administrators. Clarifying these misunderstandings is crucial to ensuring the health and safety of students participating in interscholastic athletics. Below are six common misconceptions:
Understanding these common misconceptions about the Alabama High School Physical Form is essential for athletes, parents, and school staff to navigate the requirements successfully, ensuring all students are safe and eligible for interscholastic athletical participation.
When preparing and utilizing the Alabama High School Physical Form, several essential points must be kept in mind to ensure the process is conducted smoothly and accurately. Here are eight key takeaways:
Understanding and adhering to these points ensures a smooth preparation process for student-athletes aiming to participate in high school sports in Alabama, emphasizing the importance of health and safety in athletic activities.
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