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Blank Alabama High School Physical PDF Form

The Alabama High School Physical form is a crucial document that ensures student-athletes are medically fit to participate in sports. This form collects essential health information and requires a physician's evaluation to certify that the student can safely engage in athletic activities. Completing this form is vital for compliance with state regulations and for the well-being of the student-athlete; click the button below to fill it out.

Article Guide

The Alabama High School Physical form is a crucial document for student-athletes participating in interscholastic sports. This form is designed to ensure that each athlete is physically fit and medically cleared to engage in various athletic activities. It begins with basic information, such as the athlete's name, age, address, and school details. The form then delves into the athlete's medical history, asking about past injuries, surgeries, and any ongoing health issues. Questions cover a range of topics, from respiratory problems and allergies to musculoskeletal injuries. A thorough physical examination follows, assessing vital signs and overall health, including cardiovascular and musculoskeletal evaluations. Importantly, the form requires a physician's signature to certify that the athlete is fit to compete. This certification must be updated annually to maintain eligibility for participation in sports. The emphasis on health and safety in this process underscores the importance of being proactive about physical well-being in the realm of high school athletics.

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ALABAMA HIGH SCHOOL ATHLETIC ASSOCIATION	Revised 2018
Revised 2018	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?
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
			Student's name		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
Physical Examination					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			Revised 2018
			Vision R 20 / ____ L 20 / ____ Corrected: Y N

		LIMITED		Normal		Abnormal Findings

			Cardiovascular
			Cardiovascular

			Pulses

			Heart

			Lungs

			Skin

			E.N.T.

	COMPLETE		Abdominal

			Genitalia (males)
			Genitalia (males)

			Musculoskeletal

			Neck

			Shoulder

			Elbow

			Wrist

			Hand

			Back

			Knee

			Ankle

			Foot

			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.)

Rev. 2018 (The revised 2018 form is the official form accepted by the AHSAA.)

➤ PDF File

Form Specifications

Fact Name	Details
Governing Body	The Alabama High School Athletic Association (AHSAA) oversees the physical evaluation form.
Eligibility Requirement	Students must have a current physician's statement on file to participate in interscholastic athletics.
Form Usage	The AHSAA Physicians Certificate (Form 5) is specifically required for physical evaluations.
Age Range	The form is applicable for students in grades 7 through 12.
Validity Period	A physical exam is valid for one calendar year from the date of the examination.
Physical Examination Components	The evaluation includes assessments of cardiovascular, musculoskeletal, and general health.
Signature Requirement	Both the athlete and a parent or guardian must sign the form to validate the information provided.
Medical History Questions	The form includes questions regarding past injuries, illnesses, and medical conditions.
Clearance Options	Physicians can clear students for participation, clear them with conditions, or deny clearance.
Compliance with State Law	The form is in compliance with Rule 1, Section 14 of the AHSAA regulations.

Alabama High School Physical: Usage Guidelines

Filling out the Alabama High School Physical form is an important step in ensuring that students are cleared for athletic participation. The process involves providing personal information, answering health-related questions, and obtaining a physician's evaluation. Below are the steps to complete the form accurately.

Begin by entering the athlete's Name at the top of the form.
Fill in the Sex and Age of the athlete.
Provide the Address where the athlete resides.
Indicate the School the athlete attends.
Specify the Grade the athlete is currently in.
Answer the health history questions by marking "Yes" or "No" for each item listed.
If any questions are answered "Yes," provide detailed explanations in the space provided.
Fill in the Date of Birth and Phone number of the athlete.
Select the Sport the athlete intends to participate in.
Sign the form to confirm that the information provided is accurate.
Have a parent or guardian sign the form as well.
Ensure that the physician completes the Physical Examination section, including the findings and clearance status.
Finally, make copies of the completed form as needed for school records.

Your Questions, Answered

What is the Alabama High School Physical form?

The Alabama High School Physical form is a required document for students in grades 7 through 12 who wish to participate in interscholastic athletics. This form must be completed by a licensed physician and includes both a medical history and a physical examination. It certifies that the student is physically fit to engage in sports activities, ensuring their health and safety during participation.

How often do students need to complete the physical evaluation?

A physical evaluation must be completed annually. This means that a new form is required every year to confirm that the student remains healthy and fit for athletic participation. The physical exam is valid for one calendar year from the date of the examination, so it’s important to keep track of when the last evaluation was conducted.

What information is required on the form?

The form requires various details about the student, including their name, age, address, school, and grade. Additionally, it includes a medical history section where students must disclose any previous injuries, medical conditions, or ongoing health issues. This information helps the physician assess the student's readiness for sports and identify any potential risks.

Who can perform the physical examination?

The physical examination must be conducted by a licensed physician, either a Doctor of Medicine (M.D.) or a Doctor of Osteopathy (D.O.). It is crucial that the examining physician is familiar with the requirements of the Alabama High School Athletic Association (AHSAA) to ensure that the form is filled out correctly and meets all necessary standards.

What happens if a student is not cleared for participation?

If a student is not cleared for participation, the physician will indicate the reasons on the form. They may recommend further evaluation, rehabilitation, or specify restrictions regarding the type of sports the student can participate in. It is important for the student and their guardians to follow up on any recommendations made by the physician to ensure the student’s health and safety.

Common mistakes

Incomplete Personal Information: Many individuals forget to fill in essential details such as name, age, and address. This information is crucial for identifying the student and ensuring proper documentation.
Missing Medical History: Failing to disclose previous medical conditions or injuries can lead to serious complications. It's vital to accurately report any past surgeries, allergies, or chronic conditions.
Not Seeking Clarification: Some people hesitate to ask questions if they don't understand a section of the form. It’s important to seek help to ensure all sections are completed correctly.
Ignoring Signatures: Neglecting to obtain the necessary signatures from both the athlete and a parent or guardian can render the form invalid. Ensure that all required signatures are present before submission.
Submitting Outdated Forms: Submitting a physical evaluation that is older than one calendar year will not meet the eligibility requirements. Keep track of the examination date to ensure compliance.

Documents used along the form

When preparing for participation in high school athletics in Alabama, several important documents accompany the Alabama High School Physical form. Each of these forms serves a distinct purpose, ensuring that student-athletes are healthy and cleared for sports activities. Below is a list of commonly used documents that parents and guardians should be aware of.

Medical History Form: This document collects comprehensive information about the athlete's past medical conditions, surgeries, allergies, and any current medications. It helps physicians assess any potential risks related to sports participation.
Consent to Treat Form: This form grants permission for medical staff to provide treatment in case of injury or illness during athletic activities. It is essential for ensuring that athletes receive prompt care when needed.
Emergency Contact Information: This document lists individuals to contact in case of an emergency. It is crucial for ensuring that the right people can be reached quickly if an athlete is injured or becomes ill.
Insurance Information Form: This form provides details about the athlete's health insurance coverage. It is important for medical staff to know what insurance is available for treatment costs in case of an injury.
Concussion Awareness Form: This document educates athletes and their guardians about the signs and symptoms of concussions. It also requires acknowledgment of the risks associated with head injuries in sports.
Participation Agreement: This agreement outlines the responsibilities and expectations for athletes and their families. It often includes rules regarding behavior, attendance, and commitment to the team.
Drug Testing Consent Form: Some schools require athletes to consent to random drug testing. This form ensures that athletes are aware of the policies regarding drug use and the consequences of violations.
Health Insurance Waiver: If a student does not have health insurance, this waiver may be required. It acknowledges that the school is not liable for medical expenses resulting from injuries during athletic activities.
Physical Examination Record: This document provides a summary of the athlete's physical exam results. It is often filled out by the examining physician and is necessary for confirming the athlete's fitness to participate in sports.
Parental Consent for Travel Form: If athletes travel for competitions, this form may be required to give permission for the student to travel with the team. It ensures that parents are informed and have agreed to the travel arrangements.

Understanding these documents is essential for ensuring a smooth and safe athletic experience for student-athletes. Parents and guardians should take the time to familiarize themselves with each form, as they play a crucial role in the health and safety of their children while participating in sports.

Similar forms

The Alabama High School Physical form serves as a crucial document for student-athletes, ensuring their health and readiness for sports participation. Several other documents share similarities with this form, particularly in their purpose of assessing physical fitness and medical history. Below is a list of nine documents that are comparable to the Alabama High School Physical form:

Preparticipation Physical Evaluation (PPE): Similar to the Alabama form, the PPE is used by many states to assess an athlete's health before they participate in sports. It includes a medical history and a physical examination to ensure the athlete is fit for activity.
Sports Physical Form: This document is often required by schools and sports organizations. It gathers information about the athlete's medical history and physical condition, similar to the Alabama form, to confirm their ability to participate safely.
Emergency Contact Form: While not a physical evaluation, this document is essential for ensuring that medical personnel can reach the right contacts in case of an emergency. It complements the physical form by providing crucial information about who to contact if an athlete is injured.
Health History Questionnaire: This form collects detailed medical history from the athlete, including past injuries and existing conditions. Like the Alabama form, it helps identify any potential health risks before participation.
Consent for Treatment Form: This document allows parents or guardians to consent to medical treatment for their child in case of an injury. It works alongside the physical evaluation to ensure that athletes receive prompt care when needed.
Informed Consent Form: This form outlines the risks associated with sports participation. It is similar to the Alabama form in that it ensures athletes and their guardians are aware of potential health risks before engaging in sports.
Return-to-Play Form: After an injury, this document is required to confirm that an athlete is cleared to return to sports. It parallels the Alabama form by ensuring that the athlete's health is assessed before resuming physical activity.
Medical Release Form: This document is often needed when an athlete seeks medical attention. It grants permission for healthcare providers to share medical information, similar to the Alabama form's focus on health assessments.
Annual Health Assessment Form: Many schools require this yearly assessment to monitor students' health. Like the Alabama High School Physical form, it helps track changes in an athlete's health over time and ensures they remain fit for sports participation.

Each of these documents plays a vital role in safeguarding the health of student-athletes, ensuring they are fit to compete and ready to handle the physical demands of their sports.

Dos and Don'ts

When filling out the Alabama High School Physical form, it's essential to ensure that all information is accurate and complete. Here are some important dos and don'ts to consider:

Do provide accurate personal information, including your name, age, and school.
Do answer all medical history questions truthfully to ensure safety during participation.
Do have a parent or guardian sign the form if you are under 18 years old.
Do ensure that the physician conducting the exam is licensed and qualified.
Don't leave any sections of the form blank; every question is important.
Don't exaggerate or downplay any medical conditions; honesty is crucial.
Don't forget to keep a copy of the completed form for your records.

By following these guidelines, you can help ensure that the process runs smoothly and that you are cleared for participation in sports activities.

Misconceptions

Misconception 1: The physical form is only necessary for athletes.

In reality, the Alabama High School Physical form is required for all students participating in interscholastic athletics, regardless of the sport. This ensures that every student is medically evaluated before engaging in physical activities.
Misconception 2: A physical exam is valid indefinitely.

The form states that a physical exam is valid for one calendar year. After this period, a new evaluation is necessary to ensure continued health and safety for participation in sports.
Misconception 3: Only a doctor can complete the physical evaluation.

While a licensed physician (M.D. or D.O.) must sign the form, the evaluation can also be conducted by certain qualified healthcare professionals, depending on state regulations.
Misconception 4: The form only covers physical health.

The evaluation includes questions about medical history, allergies, and previous injuries. This comprehensive approach helps identify any potential health risks that could affect a student's ability to participate safely.
Misconception 5: Parents are not involved in the process.

Parental involvement is crucial. The form requires both the athlete's and the parent or guardian's signatures, indicating that parents should be aware of their child's health status and any medical concerns.
Misconception 6: The form can be submitted at any time.

There is a specific timeline for submitting the form, typically before the start of the sports season. Late submissions may affect a student's eligibility to participate.
Misconception 7: The physical evaluation is a one-time event.

Students may need to undergo multiple evaluations throughout their high school years, especially if they have ongoing health issues or if they change sports.

Key takeaways

Here are some key takeaways about filling out and using the Alabama High School Physical form:

Complete All Sections: Ensure every section of the form is filled out accurately, including personal history and medical history.
Signature Requirement: Both the athlete and a parent or guardian must sign the form to validate the information provided.
Physician's Statement: A current physician's statement is necessary. This must confirm that the athlete has passed a physical exam.
One-Year Validity: The physical exam is valid for one calendar year from the date of the exam, so keep track of the expiration date.
Clearance Levels: The physician will indicate whether the athlete is cleared for participation, cleared after rehabilitation, or not cleared, along with reasons.
Keep a Copy: Make sure to keep a duplicate of the completed form for personal records and future reference.