Embedded Files
AthleticHistoryEng.pdfAthletic Physical Forms
Athletic Physical Forms
Make sure you have all required pages completed by your private physician and parent/caregiver.
Please make sure that all questions are answered, as this will speed the process and prevent having your physical rejected.
On the left is the two-page "HISTORY FORM" which is to be completed and signed by the parent/caregiver and the student-athlete. If you answer "Yes" to any question, please explain on the lines provided at the bottom right of page one. This page should be signed by the student and parent/caregiver and brought to your primary care provider with the next two pages listed below.
AthleticPhysicalForm.pdfOn the left is the "PHYSICAL EXAMINATION FORM" which must be completed and signed by your primary care provider.
Athletic PPE_FormOn the left is the "PREPARTICIPATION PHYSICAL EVALUATION MEDICAL ELIGIBILITY FORM" where your primary care provider will note if you are cleared for sports participation or if you need further evaluation. This is also where your physician will note any allergies or medical conditions that you have, as well as any medications that you are taking.
This is very important! At the bottom of this form, your primary care provider must sign on two signature lines and include their office stamp.
Once all of this is completed, please submit THIS PAGE ONLY to the NAHS Nurse, Main Office, or Athletic Director. All other pages must be stored at your primary care provider's office.
The determination of clearance or non-clearance is based solely on the recommendation of the Health Care Provider who completed the Medical Eligibility Form. Neither the school nurse nor the school physician is responsible for this determination.
AthleticHistorySpan.pdfThe form to the left is the same as the two-page "HISTORY FORM" but is printed in Spanish for parents who prefer that option.
Health History Updated Questionnaire.pdfHealth History Questionnaire
Health History Questionnaire
Any student whose physical examination was completed more than 90 days prior to the first day of official practice shall provide a health history update questionnaire completed and signed by the student’s parent or guardian.
This form is only a supplement to your actual athletic physical.
This form should only include new health information that has occurred after the date of your athletic physical. This is not meant to duplicate any health history information that has already been disclosed.
Any questions that are answered "Yes", must have a full explanation.
Health Information: Sudden Cardiac Death in Young Athletes
Health Information: Sudden Cardiac Death in Young Athletes
Layout 1.pdfLayout 1.pdfHealth Information: Sports-Related Eye Injuries
Health Information: Sports-Related Eye Injuries
Fact Sheet for Parents: Sports-Related Eye Injuries in Youth.pdfHealth Information: Opioid Use and Misuse
Health Information: Opioid Use and Misuse
Opioid Use and Misuse Educational Fact Sheet.pdfReport abuse