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Fill Out Your Sports Physical Template

The Sports Physical Form is a detailed document designed to assess an athlete's readiness and safety for participation in sports activities. It includes personal information, medical history, and a physical examination section to be completed by a physician, ensuring the athlete is medically qualified for sports involvement. To ensure a smooth and safe sports season, don't wait to fill out this essential form—click the button below to get started.

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Understanding the intricacies of a Sports Physical form is critical for athletes, parents, and guardians as it plays a key role in assessing an athlete's readiness and safety for participation in sports. This comprehensive form encompasses various aspects including personal information, medical history, and an exhaustive physical examination to be conducted by a qualified healthcare professional. Key personal details such as the athlete’s name, gender, date of birth, and contact information for both the athlete and their parents or guardians are required. Additionally, an emergency contact must be provided. The form highlights the importance of listing any medical alerts that could affect the athlete's performance or require immediate attention, such as allergic reactions or the use of contact lenses. A thorough medical history section prompts athletes and their families to disclose any past instances of sudden family deaths before age 50, experiences of dizziness or unconsciousness during exercise, asthma, bone fractures, concussions, heat-related illnesses, chronic conditions, medication usage, allergies, and surgeries or hospitalizations among other critical health details. These insights enable a deep dive into any potential health risks that might compromise the athlete’s safety during sports activities. Following the personal and medical information, the form outlines a physical exam section that must be completed by a physician, covering evaluations from vision tests to musculoskeletal assessments, ensuring a comprehensive health overview. The physician's certification confirms the athlete's medical eligibility for sports participation, including any recommended restrictions. This form serves as a preventative measure, aiming to minimize the risk of injuries and ensure a safe sporting experience for young athletes.

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Sports Physical Form

Name: ______________________________________ Gender: M F Date of Birth: ___/___/___

Father’s Name: _________________________ Daytime phone, pager, cell phone: _______________________

Mother’s Name: ________________________ Daytime, phone, pager, cell phone: _______________________

Street address: _____________________________________________________________________________

City: _________________ State: _______ Zip Code: __________ Home phone: ________________________

Alternate Emergency Contact Person: ______________________ Daytime phone: _______________________

Please indicate MEDICAL ALERTS such as allergic reactions, contact lenses, etc.: ______________________

__________________________________________________________________________________________

Medical History:

Athletes and parents: This health record is a critical element in the determination of an athlete’s risk of injury in sports. Please take the time to read and answer all questions before seeing a physician for the athlete’s physical examination.

1.	Has anyone in the athlete’s family (grandparents, mother, father, brother, sister, aunt,	YES	NO	Don’t Know
	uncle) died suddenly before age 50?
2.	Has the athlete ever stopped exercising because of dizziness or passed out during exercise?	YES	NO	Don’t Know
3.	Does the athlete have asthma (wheezing), hay fever, or coughing spells after exercise?	YES	NO	Don’t Know
4.	Has the athlete ever had a broken bone, had to wear a cast, or had an injury to any joint?	YES	NO	Don’t Know
5.	Does the athlete have a history of concussion (getting knocked out)?	YES	NO	Don’t Know
6.	Has the athlete ever suffered a heat-related illness (heat stroke)?	YES	NO	Don’t Know
7.	Does the athlete have a chronic illness or see a doctor regularly for any particular problem?	YES	NO	Don’t Know
8.	Does the athlete take any medication(s)?	YES	NO	Don’t Know
9.	Is the athlete allergic to any medications or bee stings?	YES	NO	Don’t Know
10.	Does the athlete have only one of any paired organs? (Eyes, ears, kidneys, testicles, ovaries)	YES	NO	Don’t Know
11.	Has the athlete had an injury in the last year that caused the athlete to miss 3 or more	YES	NO	Don’t Know
	consecutive days of practice or competition?	YES	NO	Don’t Know
12. Has the athlete had surgery or been hospitalized in the past year?		YES	NO	Don’t Know
13. Has the athlete missed more than 5 consecutive days of participation in usual activities		YES	NO	Don’t Know
	because of illness, or has the athlete had a medical illness diagnosed that has not been
	resolved in the past year?
14.	Are you, the athlete, worried about any problem or condition at this time?	YES	NO	Don’t Know

Please give details on any “YES” answer from the above health history.

____________________________________________________________________________________________________________

__________________________________________________________________________________________

PHYSICAL EXAM – TO BE COMPLETED BY PHYSICIAN

Height __________	Weight __________	Pulse __________	Blood Pressure __________
Vision: R _____ / _____ uncorrected R _____ / _____ corrected			L _____ / _____ uncorrected L _____ / _____ corrected

Normal

Abnormal Findings

1.Eyes

2.Ears, Nose, Throat

3.Mouth & Teeth

4.Neck

5.Cardiovascular

6.Chest & Lungs

7.Abdomen

8.Skin

9.Genitalia-Hernia (male)

10.Muskuloskeletal: ROM, strength, etc.

a.neck

b.spine

c.shoulders

d.arms/ hands

e.hips

f.thighs

g.knees

h.ankles

i.feet

11.Neuromuscular

Initials

Please Print/ Stamp

Physician’s Name ___________________________________________________________________________________

Street Address _____________________________________________________________________________________

City, State, Zip Code ________________________________________________________________________________

Telephone _________________________________________________________________________________________

I certify that I have examined this athlete and found him/her medically qualified to participate in sports. I also certify that I am a licensed medical physician, physician’s assistant, or family nurse practitioner. (Doctor of Chiropractic Medicine is not satisfactory.)

Physician Signature __________________________________________________________ Date __________________

PARTICIPATION RESTRICTIONS: _________________________________________________________________

__________________________________________________________________________________________________

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File Attributes

Fact	Detail
Content Requirement	The Sports Physical Form requires personal information, medical alerts, medical history, and a physical exam to be completed by a physician.
Physician Requirement	A licensed medical physician, physician’s assistant, or family nurse practitioner must complete the physical exam. Chiropractors are not accepted.
Medical History Information	The form requires detailed medical history including questions about sudden family deaths, episodes of dizziness or passing out, asthma, previous injuries, surgeries, and chronic illnesses.
Specific Inquiries	It specifically asks about issues that could affect participation in sports, such as allergies, medication use, history of concussion, or heat-related illnesses.
Governing Law(s) for State-Specific Forms	State-specific forms might be governed by different laws and regulations that tailor requirements to the state’s standards for youth sports participation.

How to Fill Out Sports Physical

Completing the Sports Physical form is an essential step for athletes, ensuring their health and safety on the field. This process involves providing detailed personal, medical, and emergency contact information, followed by a thorough examination by a qualified physician. The form captures critical medical history that might influence an athlete's ability to participate safely in sports activities. Here's a guide to filling out the form accurately.

Start with the athlete's basic information. Write the athlete's Name clearly at the top of the form.
Select the athlete's Gender by marking either "M" for male or "F" for female.
Enter the athlete's Date of Birth in the format MM/DD/YYYY.
Fill in the Father’s Name and provide a contact number that can include a daytime phone, pager, or cell phone.
Similarly, provide the Mother’s Name and a contact number where she can be reached during the day.
Under the address section, write the athlete's Street Address, including the city, state, and zip code.
Include a Home Phone number for additional contact.
Identify an Alternate Emergency Contact Person and provide a daytime phone number for them.
In the MEDICAL ALERTS section, list any critical medical conditions or allergies such as allergic reactions or the use of contact lenses.
Review the Medical History section with the athlete and a parent. Answer all the questions with "YES," "NO," or "Don’t Know."
Provide details for any "YES" answer in the designated space, explaining the nature of the condition or event.
Remember, the PHYSICAL EXAM section is to be completed by the examining physician after evaluating the athlete.
The physician will record measurements like height, weight, pulse, and blood pressure. They will also check the vision and note any normal or abnormal findings across various health categories.
Ensure the physician completes, signs, prints their name, addresses, and adds their phone number in the designated area.
Finally, note any PARTICIPATION RESTRICTIONS as advised by the physician, if there are conditions that limit the athlete's full participation in sports activities.

After every section of the form is meticulously filled out and checked for accuracy, it’s vital to review it once more for completeness. Make sure the physician’s evaluation and any recommendations are clearly noted, as this information is pivotal in maintaining the safety and health of the athlete during their sporting endeavors.

Frequently Asked Questions

What is a Sports Physical form?

A Sports Physical form is a comprehensive document that collects vital health information about a student-athlete before they participate in sports. It includes sections for personal details, medical alerts, medical history, and a physical examination by a physician. The form aims to ensure that the athlete is in good health and able to engage in sports activities safely. The collected information helps in identifying any potential risks or conditions that could affect the athlete's ability to perform or might necessitate special attention during sports activities.

Who needs to complete the Sports Physical form, and why is it important?

The Sports Physical form should be completed by both the student-athlete and a qualified healthcare professional. Initially, the athlete and their parents fill out the sections related to personal details, medical alerts, and medical history. This step is crucial for revealing any previous medical issues, allergies, or conditions that might influence the athlete's participation in sports. Following this, a licensed medical physician, physician's assistant, or family nurse practitioner conducts a physical examination and fills in the corresponding section. This form is important because it:

Ensures the safety of the athlete by identifying health concerns that could be exacerbated by sports activities.
Helps coaches and sports program administrators understand any special medical needs or precautions needed for the athlete.
Provides a legal record that the athlete has been examined and is cleared to participate in sports, which is often a requirement by schools and sports organizations.

What happens if there's a "YES" answer in the medical history section?

If any question in the medical history section is answered with "YES," the athlete or parent is required to provide details about the condition or event. This includes describing what happened, when it occurred, any diagnosis made, treatments received, and if the issue has been resolved or is ongoing. The healthcare professional conducting the physical examination will review these details to assess any risks associated with sports participation and to determine if any further evaluations or restrictions are necessary. In some cases, additional tests or consultations with specialists might be required before clearance can be given.

What are the PARTICIPATION RESTRICTIONS on the form, and how are they determined?

The PARTICIPATION RESTRICTIONS section is filled out by the examining healthcare professional and outlines any limitations or special considerations for the athlete's participation in sports. Restrictions can be temporary or permanent, depending on the athlete's medical condition. They are determined based on the findings during the physical examination, the athlete’s medical history, and any specific responses provided in the "YES" detail section. Restrictions might include limitations on certain activities, the need for protective gear beyond standard equipment, or requirements for regular medical check-ups. The goal of stating these restrictions is to protect the athlete from potential harm while allowing them to participate in sports to the fullest extent possible, given their medical conditions.

Common mistakes

Filling out a Sports Physical form is a straightforward task, yet it's not uncommon for people to stumble over certain sections, leading to inaccuracies or, worse, delays in getting cleared for participation. One of the most common mistakes is failing to provide complete information about medical history. This section is vital for assessing risk and ensuring athlete safety, yet it's often seen with blanks or non-specific answers that can leave health professionals guessing.

Another area often overlooked is the medical alerts section. Whether it's allergies, asthma, or a requirement for glasses/contacts, each detail can significantly impact an athlete's ability to perform and respond to emergencies. Missing or ignoring to fill out these alerts compromises not only the effectiveness of this health record but also the safety of the athlete during participation.

Accuracy can also take a hit when filling out contact details. It's vital to ensure that all phone numbers provided are current and correctly formatted. This includes the daytime numbers for both parents (or guardians) and the alternate emergency contact. Inaccurate or outdated contact information can severely delay or complicate the communication process in case of an emergency.

A subtle yet significant detail that often gets overlooked is the details section following any "YES" answers in the medical history. Simply ticking "YES" without providing specifics does little to inform the physician about the nature, severity, or specifics of the condition. This omission can hinder a comprehensive understanding of the athlete's health status, potentially resulting in an incorrect clearance.

The section detailing medication allergies is another critical area prone to mistakes. Inadequately documenting medication allergies or failing to mention them at all can have serious repercussions. In the event of a medical intervention where this information is crucial, omissions can lead to incorrect treatment decisions, endangering the athlete's health.

Last but not by any means least, ensuring that the form is signed and dated by the appropriate healthcare professional is a step that’s frequently missed. Without this, the form is officially incomplete, rendering the athlete ineligible for participation. This also includes ensuring that the provider is recognized and approved according to the form’s requirements, as certain professionals, like chiropractors, may not be considered satisfactory for the purpose of the sports physical certification.

Documents used along the form

When a young athlete is gearing up for a new sports season, gathering the necessary documents can feel like preparing for a major league draft. Among these critical papers is the Sports Physical Form, a stalwart in the pre-season prep checklist. However, this form doesn't stand alone in the hall of fame of essential documents. Let's take a dive into some other key forms and documents that often accompany the Sports Physical Form, ensuring our young athletes are not only physically prepared but also well-documented for the season ahead.

Emergency Medical Authorization Form: This allows designated individuals to make medical decisions for the athlete in case of an emergency when parents or guardians are not available.
Concussion Acknowledgement Form: A must-have in many states, this form educates and informs parents and athletes about the risks, signs, and symptoms of concussions.
Code of Conduct Agreement: Often required by schools or sports organizations, this document outlines expected behaviors of athletes, enforcing discipline and respect for the game, officials, and other players.
Waiver/Release for Participation: A legal document that usually needs to be signed by a parent or guardian, releasing the organization from liability in case the athlete gets injured.
Insurance Information Form: Details the athlete's current health insurance coverage, ensuring all medical treatments can be properly billed.
Travel Permission Form: Necessary for teams that participate in games or tournaments away from their home base, granting permission for the athlete to travel with the team.
Equipment Issue Form: Records what gear has been issued to the athlete by the team or school, holding them responsible for its return.
Academic Eligibility Form: Confirms the athlete is maintaining satisfactory grades to participate in sports, emphasizing the student-athlete balance.

Together, these forms create a comprehensive profile of the athlete, ensuring they are ready, safe, and eligible to hit the field, court, or track. As parents, guardians, or coaches, keeping these documents organized and updated plays a crucial role in facilitating a smooth and stress-free sports season. After all, the focus should be on the game and the growth it brings, not on last-minute paperwork scrambles. So, as you lace up those cleats or polish that basketball, remember, a well-prepared athlete is not only physically fit but also well-documented.

Similar forms

The Employment Physical Form bears a strong resemblance to the Sports Physical Form as both are indispensable in assessing an individual's physical capability to take on specific activities safely. Much like the sports version, the employment physical often includes a detailed medical history questionnaire and a physical examination section that must be filled out by a healthcare professional. These forms are designed to identify any existing health issues that could impede the person's ability to perform their job or sports activities efficiently and without risking their health.

An Annual Physical Examination Form, frequently encountered in general healthcare, shares similarities with the Sports Physical Form by providing a comprehensive health overview of an individual on a yearly basis. The inclusion of sections dedicated to medical history, medication usage, allergies, and a physical examination mirrors the structure of the sports physical, aiming to monitor and maintain overall health and prevent potential health issues from going unnoticed.

The Pre-operative Assessment Form, required before undergoing any surgical procedure, parallels the Sports Physical Form in its thorough evaluation of a patient's medical history and physical health status. This similarity underlines the importance of understanding an individual’s medical background and current health to minimize risk during and after surgery, analogous to minimizing risk during sports participation.

The School Entry Health Examination Form, necessary for enrollment in many schools, aligns with the Sports Physical Form in ensuring a child is physically and medically fit to attend school. Both documents require a detailed account of the child's medical history, vaccinations, and a physical examination to confirm the absence of any conditions that could affect their participation in school activities, including sports, highlighting the importance of safeguarding children’s health in a community setting.

The Driver's Medical Evaluation Form, needed for individuals with certain medical conditions wishing to obtain or retain a driver's license, exhibits similarities with the Sports Physical Form. Both documents scrutinize the individual’s physical and medical capability to perform specific tasks safely - driving in one case, and sports activities in the other, thus ensuring public and personal safety.

The Travel Health Consultation Form, often used by healthcare providers to assess a traveler's health status before going abroad, shares its goal of preventing health issues from arising due to physical activities, much like the Sports Physical Form. Both evaluate the individual's health and medical history, with a specific focus on mitigating risks associated with physical exertion, whether it be in sports or while traveling.

Lastly, the Immunization Record Form, while primarily a document tracking vaccination history, complements the Sports Physical Form in promoting health and safety in group activities. The Sports Physical assesses individual readiness for physical stress, whereas the Immunization Record ensures communal protection against vaccine-preventable diseases during such activities, together emphasizing a holistic approach to health and safety in communal settings.

Dos and Don'ts

When preparing to fill out a Sports Physical form, it’s crucial to ensure the accuracy and completeness of the information provided. This documentation plays a significant role in determining an athlete's readiness to participate safely in sports activities. Here are some guidelines to follow:

Do:

Review the entire form before starting to fill it out, ensuring you understand each section and what’s required.
Gather all necessary information beforehand, including the athlete’s medical history, current medications, and any known allergies.
Answer all questions truthfully and accurately. If unsure about a specific medical detail, it’s better to consult with a healthcare provider than to guess.
Provide details for any “Yes” responses in the medical history section, including dates, conditions, treatments, and the name of the attending healthcare provider.
Use legible handwriting if filling the form out by hand, to ensure all information is easily readable.
Review the form for any missed sections or unanswered questions before submitting.
Keep a copy of the completed form for your records before handing it to the sports organization.
Submit the form by the deadline, ensuring it’s received in time to process the athlete’s participation.
Update the form if any medical information changes before the start of the sports season.
Consult a physician with any concerns or questions about the athlete’s ability to participate in sports safely.

Don't:

Rush through the form without carefully considering each question and its implications for the athlete’s health and safety.
Overlook details about medical history or current health conditions that could affect the athlete’s participation in sports.
Allow the athlete to fill out the form alone if they are a minor. Parental insight and consent are necessary.
Use vague language when providing details on the medical history or health conditions. Specificity is crucial.
Assume previous conditions or medications are not relevant. If in doubt, include the information.
Forget to sign and date the form, as an unsigned form may not be processed, delaying the athlete’s participation.
Disregard the physical examination by a qualified healthcare provider, as this is a crucial step in the form completion.
Provide outdated contact information, as the sports organization needs to reach parents or guardians quickly if a health issue arises.
Ignore the participation restrictions section if present, as it may include vital information for keeping the athlete safe.
Submit the form without first making a copy for your personal records, as it serves as an important document for reference.

Misconceptions

Understanding the Sports Physical Form requires addressing common misconceptions that may arise due to a lack of clear information. Here we dispel seven of these misunderstandings to aid in a better comprehension of the form's purpose and requirements.

Only applicable to high-risk sports: A common misconception is that sports physical forms are only necessary for high-intensity or high-risk sports. In reality, this form is a prerequisite for participation in most organized sports, regardless of their perceived risk, to ensure the athlete's safety.
Substitute for a regular physical exam: Some believe that a sports physical can replace an annual physical examination. However, sports physicals are specifically designed to evaluate an athlete's fitness level for sports participation, not to provide a comprehensive health overview. An annual check-up with a healthcare provider is still recommended.
One-time requirement: The assumption that once an athlete completes a sports physical, they do not need another is incorrect. Most organizations require a new physical for each sports season or school year, acknowledging that an athlete's health status can change.
Physician's clearance guarantees safety: While securing a physician's clearance on a sports physical form suggests that an athlete is medically qualified to participate in sports, it does not guarantee immunity from injuries or health issues. Ongoing vigilance and preventive measures are still crucial.
Only physical health is assessed: It's a common misunderstanding that sports physicals solely focus on physical health. In addition to physical evaluation, these exams often include questions about mental health, nutritional habits, and use of substances. This holistic approach helps identify any factors that could affect the athlete's performance or well-being.
Completed only by physicians: A misconception exists that only medical doctors can perform and sign the sports physical form. The form, however, indicates that licensed medical physicians, physician’s assistants, or family nurse practitioners can conduct the examination. Notably, chiropractors are not recognized for this particular clearance.
Confidential information exposure: Concerns about privacy and confidential information exposure are common. The details provided in the sports physical form are used strictly for assessing fitness to participate in sports. Schools and sports organizations are obliged to protect this information under privacy laws such as HIPAA (Health Insurance Portability and Accountability Act).

In essence, the Sports Physical Form is a tool designed to ensure that participants in organized sports are medically and physically capable of engaging safely in such activities. By dispelling these misconceptions, individuals can approach the sports physical process with informed expectations and confidence.

Key takeaways

Completing the Sports Physical form is a vital step in ensuring the safety and readiness of athletes for participation in sports activities. It involves a comprehensive evaluation of the athlete's medical history and a physical examination by a qualified health professional. Here are key takeaways about filling out and using the Sports Physical form:

Accuracy is crucial: The form requests detailed information about the athlete’s medical history, including any instances of sudden family deaths, personal episodes of dizziness or fainting during exercise, asthma, and more. Providing accurate responses ensures the physician can accurately assess the athlete's health risks.
Comprehensive medical history: A section dedicated to the athlete’s medical history plays a critical role in identifying any risks that could affect their participation in sports. It includes questions about family medical history, previous injuries, chronic illnesses, medication allergies, and surgery history. This section must be completed with thorough and honest answers.
Attention to detail regarding medical alerts: The form includes a specific section for medical alerts such as allergies or the use of contact lenses. Highlighting these alerts ensures that coaches and medical personnel are aware of potential health risks or necessary precautions.
Physical examination by a qualified professional: Only a licensed medical physician, physician’s assistant, or family nurse practitioner can perform the physical examination and certify the athlete’s fitness for sports participation. Chiropractic doctors do not qualify to certify the form.
Clear communication of participation restrictions: If there are any restrictions on the athlete’s participation, these must be clearly noted on the form by the examining professional. It ensures that the athlete’s participation is safe and adjusted according to their physical condition.

Completing the Sports Physical form with diligence and care is essential for safeguarding the health and safety of athletes. It requires honest communication between the athlete, parents, and the examining health professional to provide a clear picture of the athlete’s health status and fitness for sports participation.

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