The Alabama High School Physical Form is a vital document required for students who wish to participate in interscholastic athletics. This form collects essential health information and guarantees that a licensed physician has assessed the student’s fitness for sports participation. Ensuring that this form is filled out accurately and submitted on time is crucial for eligibility in the athletic programs.
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The Alabama High School Physical form serves as a crucial document for students aspiring to participate in interscholastic athletics. This comprehensive evaluation is not merely a formality; it is designed to ensure that young athletes are in optimal health before they engage in sports activities. Key components of the form include a personal history section where students must disclose pertinent medical information. This includes any previous injuries, surgeries, or health conditions that could impact their ability to safely participate in athletics. Additionally, the physical examination section requires the assessment of various physical attributes, such as height, weight, and cardiovascular health. A physician’s certification is vital, as it confirms that an athlete has passed the physical exam and is deemed fit for participation. Furthermore, the form delineates the different levels of clearance an athlete may receive, whether cleared for all types of sports or restricted to certain activities. Collectively, these elements emphasize the importance of safety, ensuring that every student can participate in sports with a full understanding of their health. Understanding each section of the form and providing accurate information is not only a requirement but also a commitment to the health and well-being of young 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.)
Filling out the Alabama High School Physical form is an important step for athletes wishing to participate in sports. It ensures that students are in good health and ready for physical activity. You will need to provide detailed information regarding medical history and personal details. Follow the steps below to complete the form accurately.
Completing each step carefully will help ensure you are ready for your sports activities without any unexpected delays. Keep a copy of the completed form for your records, and remember that it is valid for one calendar year following the exam date.
What is the Alabama High School Physical form?
The Alabama High School Physical form is a document that students must complete to participate in high school athletics. It serves to evaluate a student-athlete's physical fitness and medical history to ensure they are healthy enough to engage in sports activities. The form must include information about any past medical issues or current medications.
Who needs to complete the form?
Any student in grades 7 through 12 planning to participate in school-sponsored sports must fill out this form. This requirement ensures that all athletes meet the health standards necessary for their safety during physical activities.
How often do I need to submit the physical form?
The physical exam documented on the form is valid for one calendar year from the date of the examination. Therefore, if a student wishes to participate in athletics for more than one year, they will need to have a new physical evaluation completed annually.
What are the sections included in the physical form?
The form consists of several sections designed to gather important medical history and physical evaluation data. Key areas include:
What happens if a student is not cleared for participation?
If a student is not cleared for participation, it may be due to specific medical findings that require attention or rehabilitation. The physician will provide recommendations on what steps need to be taken for the student to become eligible for sports participation. It's essential for the student or their guardian to follow up with healthcare providers to address any issues reported during the examination.
Completing the Alabama High School Physical form is essential for student-athletes, yet several common mistakes can easily lead to issues. One major error is failing to provide complete contact information. Many individuals neglect to fill in the phone number and address, which can create communication problems when the school needs to reach someone for urgent matters. Ensuring that all details, including your full name, age, and school, are correct is fundamental.
Another frequent mistake is not adequately addressing medical history questions. Often, athletes might misunderstand a question or overlook the importance of previous injuries. For example, a sprained ankle or past concussion should be fully explained, even if the individual thinks it is minor. Providing thorough responses helps physicians assess the athlete's readiness for sports safely.
Additionally, signatures can be a point of confusion. Both the athlete and parent or guardian are required to sign the form. Some may assume that only one signature suffices. This misunderstanding can delay the process and may even result in the student's ineligibility. It’s crucial to double-check that all necessary signatures are present before submitting the form.
Lastly, overlooking the expiration date of the physical exam can lead to unnecessary complications. The form requires a current physician's statement, stating that the student is eligible for participation. Many people forget this important detail. Regular consultation with a physician can ensure that the athlete always meets this requirement. Keeping track of the date of the exam and scheduling a new evaluation as needed is essential for uninterrupted eligibility in sports.
In accordance with the Alabama High School Athletic Association regulations, several forms and documents accompany the Alabama High School Physical form. These documents are integral to ensuring a comprehensive assessment of a student-athlete’s readiness for participation in sports. Below is a list of these additional forms, along with brief descriptions of each.
Each of these documents plays a vital role in the overall well-being and safety of student-athletes. Properly filling out and submitting these forms ensures that athletes are not only medically prepared but also supported by their families and schools as they engage in their athletic pursuits.
Sports Physical Examination Form: This document is similar as it evaluates an athlete's health before participating in sports. Both forms assess medical history and physical examinations to ensure safety during athletic activities.
Student Health History Form: Like the Alabama High School Physical form, this document collects important information about a student’s medical history to address any potential health issues before participation in sports.
National Federation of State High School Associations (NFHS) Physical Form: This form serves a similar purpose by ensuring students are physically fit and healthy enough to compete. It also requires a physician's approval for participation.
American Academy of Pediatrics Preparticipation Physical Evaluation: This document focuses on assessing the athlete's overall health and risks, mirroring the concerns outlined in the Alabama form.
State Waiver and Release Forms: These documents are often required alongside physical evaluations to protect organizations from liability. Both forms emphasize health and safety in sports participation.
Health Insurance Coverage Form: This document is related in that it ensures athletes have proper health coverage, in line with the physical evaluation's goal to promote safety and well-being in sports.
Emergency Contact and Medical Release Form: Similar to the physical form, this document identifies whom to contact in case of an injury and provides important medical information for treating the athlete.
When filling out the Alabama High School Physical form, it's essential to be thorough and accurate. Here are ten practical dos and don'ts to consider:
Following these guidelines will help ensure a smooth process for participating in athletics.
Misconceptions about the Alabama High School Physical form can impact both students and parents. Here are seven common misunderstandings:
Understanding these misconceptions can help facilitate a smoother experience when obtaining and completing the physical form, ensuring student-athletes prioritize their health and well-being.
Filling out the Alabama High School Physical form is an important step for student-athletes. Here are some key takeaways to keep in mind:
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