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Sports Physical Template

The Sports Physical Form is a crucial document designed to assess an athlete's health and readiness for participation in sports activities. This form collects important medical history and current health information, ensuring that athletes are fit to compete safely. Completing this form accurately helps identify any potential health risks and allows for informed decisions regarding athletic participation.

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The Sports Physical form is an essential document designed to ensure the health and safety of young athletes before they participate in sports activities. This form collects vital information about the athlete, including personal details such as name, gender, date of birth, and contact information for parents or guardians. It also includes a section for medical alerts, which highlights any allergies or health conditions that may affect the athlete’s performance or safety. A thorough medical history section follows, where parents and athletes must answer questions regarding family health history, past injuries, chronic illnesses, and any medications being taken. This information is crucial for healthcare providers to assess the athlete’s risk of injury and overall fitness for sports participation. Additionally, a physical examination section, to be completed by a physician, records important health metrics such as height, weight, blood pressure, and vision. The physician will also evaluate various body systems, including cardiovascular and musculoskeletal health, to determine if the athlete is medically qualified to participate in sports. Finally, the form includes a space for the physician to note any participation restrictions, ensuring that any specific health concerns are addressed before the athlete engages in sports activities.

Key takeaways

When filling out the Sports Physical form, keep the following key takeaways in mind:

Ensure all personal information is accurate, including the athlete's name, date of birth, and contact details for parents or guardians.
List any medical alerts, such as allergies or chronic conditions, clearly and completely.
Answer all medical history questions honestly. This information is vital for assessing the athlete's health risks.
Consult with the athlete about their family medical history, especially concerning sudden deaths or hereditary conditions.
Prepare for the physician's examination by knowing the athlete's height, weight, and any current medications they are taking.
Be aware of any recent injuries or surgeries the athlete has had, as this information impacts their ability to participate in sports.
Keep a record of any "YES" answers in the medical history section to discuss with the physician.
Ensure the physician completes the physical exam section thoroughly, including all necessary measurements and assessments.
Obtain the physician's signature and date to validate the examination and approval for sports participation.

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Documents used along the form

When preparing for sports participation, the Sports Physical form is just one of several important documents that athletes and their families may encounter. Each of these forms serves a unique purpose in ensuring the safety and well-being of young athletes. Below is a list of other commonly used forms and documents that complement the Sports Physical form.

Emergency Contact Form: This document provides essential information about who to contact in case of an emergency. It typically includes names, relationships, and phone numbers of individuals who can be reached if a parent or guardian is unavailable.
Consent to Participate Form: This form is a legal document that must be signed by a parent or guardian, granting permission for the athlete to participate in sports activities. It often includes a waiver of liability, acknowledging the risks associated with sports.
Medical History Form: This document captures the athlete's past medical conditions, surgeries, allergies, and medications. It helps healthcare providers understand the athlete's health background and any potential risks before participation.
Residential Lease Agreement: This legal document establishes the agreement between a landlord and tenant, ensuring both parties understand their rights and responsibilities. For further details, you can refer to the https://californiadocsonline.com/residential-lease-agreement-form.
Insurance Information Form: This form collects details about the athlete's health insurance coverage. It ensures that any medical expenses incurred during sports activities can be processed efficiently.
Code of Conduct Agreement: This document outlines the expected behavior and responsibilities of athletes, coaches, and parents. Signing this agreement reinforces the importance of sportsmanship and respect within the team environment.
Transportation Consent Form: This form provides permission for the athlete to travel to and from events with designated individuals. It is particularly important for team travel arrangements and ensures that parents are aware of their child's transportation plans.

By understanding and completing these forms, families can help create a safe and organized environment for young athletes. Each document plays a vital role in safeguarding the athlete's health and ensuring a positive sports experience.

Dos and Don'ts

When filling out the Sports Physical form, it is important to follow some guidelines to ensure accuracy and completeness. Here’s a list of things you should and shouldn’t do:

Do read the entire form carefully before starting to fill it out.
Do provide accurate and up-to-date information about the athlete's medical history.
Do ensure that all required fields are completed, including emergency contact details.
Do discuss any medical concerns with the physician during the physical examination.
Don't leave any questions unanswered; if unsure, mark "Don’t Know" rather than skipping.
Don't exaggerate or downplay any medical issues; honesty is crucial for safety.
Don't forget to have the physician sign and date the form after the examination.

Common mistakes

Completing a Sports Physical form is essential for ensuring the health and safety of young athletes. However, many individuals make mistakes that can lead to delays or complications. One common error is failing to provide complete contact information. The form requires both parents' names and their daytime contact numbers. Omitting any of this information can hinder communication in case of an emergency.

Another frequent mistake is neglecting to disclose relevant medical history. Parents and athletes may overlook the importance of answering questions about past injuries, illnesses, or family medical history. For instance, if an athlete has a history of concussions or a family member has died suddenly before age 50, these details are crucial for assessing risk. Incomplete or inaccurate answers can lead to inadequate medical evaluations.

Many individuals also misinterpret the medical alert section. This part of the form is designed to highlight any allergies or medical conditions that could affect the athlete's performance or safety. Failing to indicate allergies to medications or the presence of conditions like asthma can pose serious risks during physical activities.

Additionally, some parents may rush through the form without discussing it with their child. Engaging the athlete in this process is vital. It ensures that they understand their own health conditions and can provide accurate answers. Rushed or uninformed responses may lead to misunderstandings during the physical examination.

Lastly, neglecting to follow up on the physician's recommendations can be detrimental. After the physical examination, the physician may provide specific participation restrictions or advice. Ignoring these recommendations can jeopardize the athlete's health and safety. It is essential to take these guidelines seriously and to communicate them clearly to the athlete.

File Characteristics

Fact Name	Details
Purpose of the Form	The Sports Physical Form is designed to assess an athlete's health and readiness to participate in sports activities.
Medical History Importance	Providing a comprehensive medical history helps identify potential health risks that could affect an athlete's performance and safety.
Emergency Contact Requirement	An alternate emergency contact must be listed to ensure immediate communication in case of an emergency.
Age Requirement	Typically, athletes must be at least 12 years old to complete a sports physical, but this can vary by state regulations.
Family Medical History	The form includes questions about family medical history to assess genetic risks, such as heart conditions.
Physical Examination	A licensed medical professional must complete the physical examination section, ensuring a qualified assessment of the athlete's health.
State-Specific Forms	Some states have specific forms that must be used, governed by local laws regarding youth sports participation.
Medication Disclosure	Athletes are required to disclose any medications they are currently taking to ensure safety during sports activities.
Allergy Information	It's essential to indicate any allergies, as this information can be crucial during emergencies.
Validity Period	Sports physicals are usually valid for one year, after which a new examination is required to ensure ongoing safety.

Form Sample

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: _________________________________________________________________

__________________________________________________________________________________________________