The Alabama High School Athletic Association Preparticipation Physical Evaluation Form is a mandatory health assessment document required for student athletes before they participate in high school sports. This comprehensive form encompasses medical history, a physical examination, and a clearance section to ensure the athlete's fitness for interscholastic athletics in grades 7-12. For a streamlined process to fulfill this requirement and keep your athletic dreams in motion, click the button below to fill out the form.
In the realm of high school sports, safeguarding the health and well-being of student-athletes is paramount. The Alabama High School Athletic Association (AHSAA) takes this responsibility seriously, mandating a comprehensive Preparticipation Physical Evaluation Form as a cornerstone of its health and safety protocols. This detailed form serves a dual purpose: it screens for potential health issues that could make sports participation unsafe and ensures compliance with state requirements for athletic participation. From personal and family health history to an extensive physical examination conducted by a qualified physician (M.D. or D.O.), each section of the form is designed to identify any medical conditions or previous injuries that may affect a student's ability to safely engage in sports. It covers everything from vision and cardiovascular health to musculoskeletal conditions, and requires disclosures about past hospitalizations, allergies, and even the specifics of any periodic medications taken by the student. Furthermore, the form requests detailed responses regarding past experiences of concussions, fractures, and surgeries, aiming to construct a comprehensive health profile for each athlete. This thorough evaluation culminates in a physician's clearance, categorizing students into those fully cleared for participation, those cleared pending further evaluation or rehabilitation, and those not cleared for activities categorized by their intensity from collision and contact sports to non-strenuous activities. This systematic approach underscores the AHSAA's commitment to athlete safety, operationalizing a standard where the health of student-athletes always comes first.
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.)
For many students in Alabama, participating in high school athletics is a significant part of their high school experience, offering opportunities for personal growth, teamwork, and physical fitness. However, before diving into the season, it's crucial to ensure that every athlete is physically ready and safe to participate. This is where the Alabama High School Preparticipation Physical Evaluation Form plays a vital role. It is designed to assess the athlete's medical history and current physical condition, ensuring they are fit to join in the athletic activities. Here’s a guide to help you accurately fill out the form.
Once both sections are correctly filled out and have been reviewed, the form should be filed in the Superintendent's or Principal's office as a part of the student’s athletic records. Remember, this physical evaluation is essential not just for meeting the requirements of the Alabama High School Athletic Association (AHSAA), but more importantly, for safeguarding the health of student athletes as they engage in sports activities. Ensuring the form is accurately and thoroughly completed is a critical step in this process.
The Alabama High School Physical Form is required for students who wish to participate in interscholastic athletics. It documents a thorough physical examination to ensure the student is medically and physically capable of engaging in sports activities. The form covers a student's medical history, physical examination results, and the examining physician's clearance status. This ensures the health and safety of student athletes by confirming they are fit for participation in sports, preventing injuries, and promoting a healthy sports environment.
Any student in grades 7 through 12 attending an Alabama high school who wishes to participate in interscholastic athletics must have a completed Alabama High School Physical Form on file. This requirement applies to all athletes, regardless of whether they are new to a sport or returning participants. The form must be filled out and signed by both the student (athlete) and their parent or guardian, and must be certified by a licensed physician (MD or DO).
The form requires a comprehensive range of information, divided mainly into two sections: the athlete’s medical history and the physical examination results. Highlights include:
The Alabama High School Physical Form is valid for one calendar year from the date of the physical examination. This means that student athletes are required to undergo a physical examination and submit a new form each year to maintain their eligibility for interscholastic athletics. It’s important for students and parents to keep track of the examination date to ensure that the form is timely renewed, avoiding any disruption in the student’s ability to participate in their chosen sports.
Completing the Alabama High School Athletic Association Preparticipation Physical Evaluation Form is a crucial step for student-athletes. Unfortunately, mistakes can occur during this process. Here are ten common mistakes:
Failing to fill out the entire history section, including omitting details about past injuries or medical conditions. This information is fundamental for assessing an athlete's readiness.
Incorrectly marking the "Yes" or "No" options, leading to confusion about the athlete's medical history. It's essential to review these carefully.
Not providing explanations for "Yes" answers in the specified area below the questions. Detailed information helps medical professionals understand the context and severity of past health issues.
Omitting the date of birth or incorrectly filling it out can lead to inaccuracies in the athlete's medical records.
Leaving the emergency contact information blank. This is critical for ensuring the athlete's safety.
Forgetting to list current medications, both prescription and over-the-counter, which could affect the athlete’s health during physical activities.
Not having the signature of the athlete and a parent/guardian at the end of the form. This oversight can render the form unofficial.
Skipping the physical examination section, including vital signs like blood pressure and heart rate, which are necessary for determining physical fitness.
Misreading or not completing sections related to vision, hearing, or other special testing that might have been conducted. These are important for a comprehensive health evaluation.
Ignoring to fill out or incorrectly completing the clearance section, which is essential for documenting the athlete’s eligibility and restrictions.
Addressing these common errors ensures a smoother evaluation process and helps safeguard the health and safety of student-athletes participating in interscholastic athletics.
When preparing for participation in high school athletics in Alabama, the Alabama High School Athletic Association Preparticipation Physical Evaluation Form is a crucial document. However, ensuring a comprehensive understanding and compliance with health and eligibility requirements often entails completing and submitting several additional forms and documents. The following list highlights other essential forms and documents typically used alongside the Alabama High School Physical form to streamline the process for students, parents, and guardians.
In order to ensure a smooth and hassle-free experience, it's advisable for students and their families to prepare these documents in advance and keep them readily accessible. Managing these administrative tasks well before the sports season begins can help in focusing on training and performance without worrying about eligibility issues. By understanding the importance of each document and taking proactive steps, students can seamlessly integrate into their chosen sports programs and enjoy a fulfilling high school athletic career.
The Pre-employment Physical Examination Form is similar to the Alabama High School Physical Form in terms of assessing the physical capability of an individual to participate in certain activities. In the case of the pre-employment form, the aim is to determine if an individual is physically capable of handling the job responsibilities.
Annual Health Assessment Form for Nursing Homes shares similarities in gathering comprehensive health information to ensure the resident's physical condition is suitable for living in a care facility, much like the Alabama form assesses fitness for sports participation.
The Sports Club Membership Health Form parallels the Alabama High School Physical Form by requiring health information and a physical examination to ensure members can safely participate in club activities and sports.
College Athletic Physical Examination Form is similar because it evaluates the health and physical fitness of students before they join college-level sports teams, ensuring they meet the physical demands of their chosen sports.
The Military Entrance Processing Station (MEPS) Physical Assessment closely resembles the form in its thoroughness in assessing an individual’s physical fitness before being deemed suitable for military training and service.
Driver’s License Health Check Form in some states requires a physical examination to ensure the applicant is physically fit and does not have medical conditions that could impair driving ability, similar to how the Alabama form assesses physical fitness for sports.
Child and Adolescent Health Examination Form used in schools for assessing the health status of students often includes sections similar to the Alabama form, focusing on physical health and ability to participate in school activities safely.
Summer Camp Physical Examination Form is required for campers to ensure that they are physically able to participate in camp activities, similar to the purpose of the Alabama High School form in assessing readiness for athletic participation.
The Immigration Physical Exam Form possesses similarities by requiring a comprehensive physical examination to ensure that the individual does not have any communicable diseases or medical conditions that would make them inadmissible, akin to assessing an athlete's physical capability.
Professional Sports Physical Examination Form used by professional sports teams to assess the physical fitness and health of their athletes before the season begins, ensuring they can meet the physical demands of their sport, reflects a similar purpose to the Alabama High School Physical Form.
Filling out the Alabama High School Physical Form is a necessary step for students who wish to participate in high school athletics. It’s crucial that the information provided is accurate and complete to ensure the safety and eligibility of the student athlete. Here are some dos and don'ts to consider when completing the form:
By following these guidelines, you can ensure a smoother process for completing the Alabama High School Physical Form, paving the way for a safe and successful athletic experience.
When it comes to the Alabama High School Physical Form, numerous misconceptions circulate, often leading to misunderstandings among students, parents, and even educators. Addressing these can clarify the form's purpose and requirements.
Misconception 1: The physical form is only for male athletes. This idea likely stems from traditional views on sports participation. However, the Alabama High School Athletic Association requires this form for all student-athletes, regardless of gender, to ensure everyone's health and safety in sports.
Misconception 2: You only need to fill out the form once during your high school career. The form must be updated and submitted annually, as it verifies a student's physical condition for the current year, reflecting any changes in health status.
Misconception 3: All sections of the form are compulsory for every student. While most of the form is mandatory, certain sections might not apply to every individual. For instance, questions related to menstruation are irrelevant to male students.
Misconception 4: A family doctor's signature isn’t necessary. Only licensed medical doctors (M.D. or D.O.) can certify the form. This ensures the examination is thorough and meets the athletic association's standards.
Misconception 5: The form is exclusively for diagnosing new medical conditions. Its primary goal is to assess a student's fitness for sports participation, not to provide a comprehensive health examination or diagnose new conditions.
Misconception 6: If you pass the physical, you are automatically cleared for all sports. A student may be cleared for general participation but might require additional evaluation for specific sports based on medical history or physical findings.
Misconception 7: Digital submissions of the form are acceptable. Typically, the original document must be submitted to ensure authenticity, though policies may vary by school or district.
Misconception 8: The physical examination doesn't assess mental health. While primarily focused on physical health, the form includes sections where doctors can note concerns that might affect a student's mental health and sports participation, like concussion history.
Misconception 9: The form covers only sports-related health issues. Although sports fitness is the focus, the form also prompts review of general health areas, including allergies and chronic illnesses, to ensure full participation safety.
Misconception 10: There’s no need for a parent or guardian’s signature if the student is 18. The form requires a parent or guardian’s signature regardless of the student’s age, emphasizing the family's awareness and agreement to the student’s participation in sports.
Clarifying these misconceptions enhances understanding and compliance with the Alabama High School Athletic Association's regulations, ensuring a safer and more inclusive environment for all student-athletes.
For Alabama high school students looking to participate in interscholastic athletics, understanding the Preparticipation Physical Evaluation Form is crucial. Here are nine key takeaways to guide you through filling out and using the form effectively:
Remembering these key points will help students, parents, and guardians navigate the requirements for participating in Alabama high school athletic programs effectively and safely.
What All Do You Need to Sell a Car - Allows for the update and replacement of registration details for those who have exchanged or relinquished special plates.
2 Step Tb Test Form - Documents the administration details of the two-step Mantoux test, including date, time, and arm of administration.
Imm 5645 - It's used across multiple application types, including student, worker, and visitor visas, making it versatile.