The Alabama High School Physical form is a document required for students participating in interscholastic athletics. This form ensures that a licensed physician evaluates the student's health and fitness for sports participation. Completing the form is essential for eligibility, so be sure to fill it out by clicking the button below.
For students eager to participate in high school sports in Alabama, completing the Alabama High School Physical form is a crucial step. This form serves multiple purposes, primarily ensuring that young athletes are in good health and ready to engage in physical activities safely. It begins with collecting essential personal information, such as the student's name, age, and school, which helps to identify the athlete. The form then delves into the athlete's medical history, asking about any past injuries, chronic conditions, or allergies that could impact their ability to participate in sports. Questions regarding previous surgeries and current medications are also included to provide a comprehensive view of the athlete's health status. After the medical history, a physical examination is conducted by a qualified physician, who assesses various aspects of the athlete's health, including cardiovascular fitness, musculoskeletal strength, and overall physical condition. This evaluation culminates in a physician's statement certifying that the student is fit to participate, which must be filed with the school’s administration. It is important to note that this certification is valid for one calendar year, ensuring that the athlete's health is regularly monitored. By completing this form, students not only comply with Alabama High School Athletic Association regulations but also prioritize their health and safety in sports.
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.)
Completing the Alabama High School Physical form is an essential step for student-athletes. This form gathers important medical information and ensures that students are physically prepared to participate in sports. Below are the steps to fill out the form accurately.
What is the Alabama High School Physical form?
The Alabama High School Physical form is a document required by the Alabama High School Athletic Association (AHSAA) for students participating in interscholastic athletics. It includes a preparticipation physical evaluation and medical history to ensure that students are physically fit to engage in sports activities.
Who needs to fill out the physical form?
All students in grades 7-12 who wish to participate in interscholastic athletics must complete the physical form. This requirement applies to all sports, regardless of the level of contact involved.
What information is required on the physical form?
The form collects basic information such as the athlete's name, age, address, school, and grade. Additionally, it includes a detailed medical history, asking about past injuries, surgeries, and any ongoing health issues. The form also requires a signature from both the athlete and a parent or guardian.
How often do students need to complete the physical exam?
A physical exam must be completed annually. The results of the physical exam are valid for one calendar year from the date of the exam. After that period, a new physical evaluation is necessary for continued participation in sports.
Who can perform the physical examination?
The physical examination must be conducted by a licensed physician, either an M.D. (Doctor of Medicine) or a D.O. (Doctor of Osteopathic Medicine). This ensures that the evaluation meets the standards set by the AHSAA.
What happens if a student is not cleared to participate?
If a student is not cleared for sports participation, the examining physician will indicate the reason on the form. This may include restrictions based on the student's health condition or previous injuries. The physician may also provide recommendations for rehabilitation or further evaluation.
Is there a specific form that must be used?
Yes, the AHSAA requires the use of a specific form known as the AHSAA Physicians Certificate (Form 5). This form must be submitted to the Superintendent's or Principal's office to be kept on file for eligibility purposes.
What should parents do if they have questions about the physical form?
Parents should contact their child's school athletic department or the school nurse for any questions regarding the physical form. They can provide guidance on completing the form and any specific requirements that may apply to their school or district.
Where can I obtain the Alabama High School Physical form?
The physical form can typically be obtained from the school’s athletic department or downloaded from the AHSAA website. Schools may also provide copies during sports registration events or orientation sessions.
Filling out the Alabama High School Physical form can be straightforward, but many people make common mistakes. One frequent error is not providing complete personal information. It’s essential to include the athlete's full name, age, and address accurately. Missing or incorrect details can lead to delays in processing the form.
Another mistake is skipping the medical history questions. These questions are crucial for understanding any past injuries or medical conditions that could affect participation in sports. Athletes should take their time to answer each question thoroughly. Incomplete answers may raise concerns later on.
People often overlook the importance of signatures. Both the athlete and a parent or guardian must sign the form. Without these signatures, the form may be considered invalid. It is a good practice to double-check that all required signatures are present before submission.
Some individuals might not keep a copy of the completed form. Having a duplicate can be helpful for personal records and in case the school needs to refer back to it. It’s a simple step that can save time and hassle later.
Lastly, failing to update the form annually is a common oversight. The physical exam is valid for one calendar year, and it’s important to ensure that the form reflects the most current information. Keeping track of the expiration date can help athletes stay eligible for participation in sports.
When participating in high school athletics in Alabama, several forms and documents accompany the Alabama High School Physical form. These documents ensure that students are medically cleared and that parents are informed about their child's health and safety. Below is a list of commonly used forms.
These forms work together to ensure the health and safety of student-athletes. Completing and submitting them is essential for participation in high school sports in Alabama.
The Alabama High School Physical form shares similarities with several other documents that serve to assess the health and readiness of students for athletic participation. Below are nine documents that have comparable purposes or components.
When filling out the Alabama High School Physical form, it is essential to approach the process with care and attention to detail. Below is a list of things you should and shouldn't do to ensure the form is completed correctly.
By following these guidelines, you can help ensure that the physical evaluation process goes smoothly, allowing for a safe and enjoyable athletic experience.
Understanding the Alabama High School Physical form is crucial for students and parents involved in athletics. However, several misconceptions often arise regarding its purpose and requirements. Here are seven common misconceptions:
This is not true. All students participating in interscholastic athletics, regardless of the sport's contact level, must submit a physical form.
Actually, a new physical exam is required every year. The exam is valid for one calendar year from the date it is completed.
This is incorrect. The form must be signed by a licensed physician (M.D. or D.O.) to certify that the student is fit for participation in athletics.
In reality, the form requires thorough answers regarding the student's medical history and any previous injuries or conditions.
Both the athlete and a parent or guardian must provide information and signatures on the form.
The exam must be conducted by a licensed physician (M.D. or D.O.) to ensure it meets the requirements set by the Alabama High School Athletic Association.
This is a misconception. Students with chronic conditions may still be cleared to participate, but they may need to provide additional documentation or follow specific recommendations from their physician.
Clarifying these misconceptions can help ensure that students are properly prepared for their athletic participation and that they meet all necessary requirements.
When filling out the Alabama High School Physical form, it is essential to follow specific guidelines to ensure accuracy and compliance. Below are key takeaways to consider:
Ensuring that all sections of the form are filled out correctly will facilitate a smoother process for athletic participation. Take the time to review the form thoroughly before submission.