HEALTH OFFICE FORMS
HEALTH OFFICE FORMS FOR PARTICIPATION IN A SPORT
The following Health Office forms are available for download.
Español (Formulario de Historial Médico)
Any student participating on a school team requires a physical examination within 365 days prior to the first practice session.
Pre-Participation Physical Examination Form
English (History & Exam Form)
THE PHYSICAL EXAM MUST BE DOCUMENTED ON THE FORM PROVIDED HERE.
FORM ALSO AVAILABLE FROM THE SCHOOL NURSE OR TEAM COACH.
This form has two parts. Parent/guardian fills out and signs the History Form. The entire form is then given to the medical provider who completes the Physical Examination Form. Return completed forms to the school nurse.
The school physician is available for sports physicals each school year. If you wish your child examined at school, complete and sign the History Form and return it to the school nurse with a note requesting this service. If you have further questions, contact the school nurse.
ADDITIONAL FORMS REQUIRED FOR SPORTS PARTICIPATION THAT MUST BE REVIEWED AND SIGNED BY THE PARENT/GUARDIAN:
Sports-Related Concussion & Head Injury Fact Sheet
Sudden Cardiac Death in Young Athletes
Sudden Cardiac Death Pamphlet Sign-Off Sheet
Health History Update Questionnaire
(To be completed by parent/guardian when physical exam is more than 90 days prior to participation)
Physical Exam Form.pdfMedication Permission Form.pdfASTHMA Action Plan.pdfHealth Office.pdf