The Alabama High School Physical form is a document required for students participating in interscholastic athletics. This form includes a preparticipation physical evaluation, which ensures that athletes are medically cleared to engage in sports activities. It is essential for parents and guardians to fill out this form accurately to support their child's health and eligibility.
To complete the process, please fill out the form by clicking the button below.
The Alabama High School Physical Form is a document required for students participating in interscholastic athletics. It certifies that a student has undergone a physical examination and is deemed fit to participate in sports activities.
All students in grades 7-12 who wish to participate in interscholastic athletics must complete the form. This includes students involved in any sports offered by their school.
A physical exam must be conducted annually. The results from the exam are valid for one calendar year from the date of the examination.
The form requires basic personal information such as the athlete's name, sex, age, address, school, and grade. It also includes a medical history section where the athlete must disclose any past injuries, medical conditions, or surgeries.
If a student has a medical condition, it must be reported on the form. The examining physician will assess the condition and determine if the student is cleared for participation in sports. The physician may provide recommendations based on the student's health status.
The physical examination must be conducted by a licensed physician, either a Medical Doctor (M.D.) or a Doctor of Osteopathy (D.O.).
The physician's signature on the form indicates that the athlete has been examined and is cleared to participate in sports. It serves as an official certification of the athlete's health status.
If the athlete is not cleared, the physician will specify the reasons and any necessary restrictions. The athlete may need to complete rehabilitation or further evaluations before being allowed to participate.
The completed form should be submitted to the Superintendent's or Principal's office at the athlete's school. It must be on file before the student can participate in any athletic activities.
Yes, the form can be duplicated as needed. Schools may require multiple copies to keep on file for different sports or seasons.
When preparing for participation in high school athletics in Alabama, several forms accompany the Alabama High School Physical form. Each document serves a specific purpose, ensuring that athletes are fit for competition and that their health information is properly recorded. Below is a list of essential forms that are commonly used alongside the physical evaluation.
Each of these documents plays a critical role in ensuring the safety and well-being of student-athletes. Proper completion and submission of these forms help schools manage health risks and maintain compliance with athletic regulations. Make sure to review each form carefully and consult with school officials if any questions arise.
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 can be a straightforward process, but several common mistakes can lead to complications. One significant error is failing to provide complete personal information. This includes the athlete's name, age, address, and school. Incomplete information can delay the processing of the form and may affect the athlete's eligibility to participate in sports.
Another frequent mistake involves not disclosing relevant medical history. Athletes must answer questions about past injuries, surgeries, and medical conditions accurately. Omitting this information, even unintentionally, can pose serious risks during athletic participation. Coaches and medical staff rely on this information to ensure the safety and well-being of the athlete.
Additionally, many individuals overlook the importance of obtaining the required signatures. Both the athlete and a parent or guardian must sign the form. Without these signatures, the form is not valid, and the athlete may be barred from participating in sports until the issue is resolved.
Finally, individuals often neglect to keep a copy of the completed form. Having a duplicate is essential for personal records and can be useful in case of any disputes or questions regarding the athlete's eligibility. It is crucial to remember that the form must be submitted to the appropriate school officials to ensure compliance with athletic regulations.
14653 Form - This form simplifies the process for taxpayers needing to rectify past reporting errors.
For those interested in becoming authorized lottery retailers in Florida, obtaining the Florida Lottery DOL-129 form is a critical first step. This form must be completed accurately and submitted with a non-refundable application fee, setting the stage for acquiring a Florida Lottery ID and undergoing necessary background checks. The application process emphasizes the importance of revealing business and personal details of all owners and key stakeholders, which reflects the Florida Lottery's dedication to maintaining integrity and security. More information can be found at floridaformspdf.com/printable-florida-lottery-dol-129-form/.
4-point Home Inspection Checklist - Aluminum wiring remediation must be documented by certified electricians if present.
Erc Forms - Checking market trends informs decision-making on pricing and marketing adjustments.