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Blank Sports Physical PDF Form

The Sports Physical Form is a crucial document designed to assess an athlete's health and readiness for participation in sports activities. It collects essential information about the athlete's medical history, current health status, and any potential risks that may affect their ability to safely engage in sports. Completing this form accurately is vital for ensuring the athlete's safety and well-being during physical activities; click the button below to fill it out.

Content Overview

The Sports Physical form serves as an essential document for young athletes, ensuring their health and safety while participating in sports. It collects vital information about the athlete, including personal details such as name, gender, and date of birth, as well as contact information for parents or guardians. The form requires a comprehensive medical history, prompting families to disclose any relevant health issues, allergies, or past injuries that could affect the athlete's performance or safety. Questions about family medical history, exercise-related incidents, and chronic conditions help assess potential risks. A physician then conducts a physical examination, measuring key health indicators like height, weight, pulse, and blood pressure. They also evaluate the athlete's vision and overall physical condition, noting any abnormalities. Finally, the physician certifies the athlete's readiness to participate in sports, while also specifying any participation restrictions that may apply. This thorough process aims to protect young athletes, ensuring they are fit for the physical demands of their chosen sports.

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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: _________________________________________________________________

__________________________________________________________________________________________________

➤ PDF File

Form Specifications

Fact Name	Details
Purpose	The Sports Physical form assesses an athlete's health and readiness for sports participation.
Required Information	The form collects personal details, including name, gender, and contact information for parents or guardians.
Medical Alerts	Parents must indicate any medical alerts, such as allergies or special conditions, to ensure athlete safety.
Health History	The form includes questions about the athlete's family medical history and personal health issues.
Physical Examination	A licensed medical professional must complete the physical exam section, evaluating the athlete's overall health.
State-Specific Forms	Some states have specific requirements for the Sports Physical form, governed by local laws.
Validity	Most states require a new physical examination annually or prior to the start of a sports season.
Participation Restrictions	Physicians can note any restrictions on the form, ensuring athletes do not engage in unsafe activities.
Signature Requirement	A physician's signature certifies that the athlete is medically cleared to participate in sports.
Confidentiality	The information provided on the Sports Physical form is confidential and should be handled with care.

Sports Physical: Usage Guidelines

Completing the Sports Physical form is essential for ensuring that the athlete is ready for participation in sports activities. After filling out the form, it will need to be reviewed and signed by a physician. Below are the steps to accurately fill out the form.

Begin by entering the athlete's Name in the designated space.
Indicate the athlete's Gender by circling either M or F.
Fill in the Date of Birth using the format MM/DD/YYYY.
Provide the Father’s Name and contact number, including daytime phone, pager, or cell phone.
Provide the Mother’s Name and contact number, including daytime phone, pager, or cell phone.
Enter the Street Address, City, State, and Zip Code for the athlete's residence.
Fill in the Home Phone number.
List an Alternate Emergency Contact Person and their daytime phone number.
Indicate any MEDICAL ALERTS such as allergies or contact lenses.
Answer the medical history questions by circling YES, NO, or Don’t Know for each item.
If any questions are answered with YES, provide details in the space provided.
Leave the PHYSICAL EXAM section blank, as this will be completed by the physician.
Ensure the physician fills in their Name, Street Address, City, State, Zip Code, and Telephone.
The physician must sign and date the form, certifying the athlete's medical qualification.
Finally, if there are any PARTICIPATION RESTRICTIONS, provide details in the designated area.

Your Questions, Answered

What is the purpose of the Sports Physical form?

The Sports Physical form is designed to assess an athlete's health and readiness to participate in sports. It collects essential information about the athlete's medical history, current health status, and any potential risks that could arise during physical activity. Completing this form helps ensure that athletes are fit to engage in sports safely, reducing the likelihood of injury and promoting overall well-being.

Who needs to complete the Sports Physical form?

All athletes participating in school or organized sports are required to complete the Sports Physical form. This includes students of all ages, from elementary school to high school. Parents or guardians should assist younger athletes in filling out the form accurately, ensuring that all medical history and relevant information are disclosed.

What information is required on the Sports Physical form?

The form requires personal details such as the athlete's name, gender, date of birth, and contact information for parents or guardians. It also asks about medical alerts, family medical history, and any past injuries or illnesses. Additionally, a physician must complete a physical examination section, which includes vital signs and assessments of various body systems.

How often should the Sports Physical form be completed?

The Sports Physical form typically needs to be completed annually. This ensures that the athlete's health is regularly assessed, and any changes in their medical status are documented. Schools or sports organizations may have specific deadlines for submission, so it is important to stay informed about those requirements.

What happens if an athlete has a medical condition?

If an athlete has a medical condition, it is crucial to disclose this information on the Sports Physical form. The physician will review the details and may recommend participation restrictions or additional evaluations. Transparency about medical conditions helps ensure the athlete's safety and allows for appropriate accommodations during sports activities.

Common mistakes

Incomplete Personal Information: Many individuals forget to fill in all personal details, such as the athlete's name, date of birth, and contact information for parents or guardians. This can delay processing and create confusion.
Neglecting Medical Alerts: Some people overlook the section for medical alerts. Not noting allergies or existing medical conditions can lead to serious risks during sports activities.
Inaccurate Medical History: It is crucial to answer all medical history questions honestly. Some may skip questions or answer "Don’t Know" when they actually have relevant information. This can affect the athlete's safety.
Forgetting Physician Information: Individuals sometimes forget to provide complete details about the physician who performed the physical examination. This includes the physician’s name, signature, and contact information, which are essential for verification.
Ignoring Participation Restrictions: If there are any restrictions or special considerations, they should be clearly noted. Failing to communicate these can lead to inappropriate participation in sports activities.

Documents used along the form

When preparing for sports participation, the Sports Physical form is just one of several important documents. Here’s a list of other forms and documents that are often used alongside it. Each plays a vital role in ensuring the safety and readiness of young athletes.

Medical Release Form: This document gives permission for medical treatment in case of an emergency. Parents or guardians must sign it to ensure that medical professionals can act quickly if needed.
Consent to Participate Form: This form confirms that parents or guardians agree to allow their child to participate in sports activities. It often includes information about the potential risks involved.
Insurance Information Form: This form collects details about the athlete's health insurance. It ensures that any medical costs incurred during sports activities can be covered.
Emergency Contact Form: This document lists people who can be contacted in case of an emergency. It’s crucial for coaches and medical staff to know who to reach out to if something happens.
Concussion Awareness Form: This form educates parents and athletes about the signs and symptoms of concussions. It often requires a signature to acknowledge understanding of the risks.
Waiver of Liability: This document releases the sports organization from liability in case of injury. Parents or guardians must sign it to participate in certain sports activities.
Health History Form: Similar to the Sports Physical form, this document gathers detailed information about the athlete’s medical history. It helps ensure that coaches and medical staff are aware of any health concerns.
Behavioral Contract: This form outlines expected behavior and responsibilities of the athlete. It promotes good sportsmanship and accountability within the team.

Having these documents in order helps ensure a smooth experience for both athletes and their families. They provide essential information and permissions that keep everyone safe and informed during sports activities.

Similar forms

Medical History Form: Similar to the Sports Physical form, a medical history form collects information about an individual's past health conditions and family medical history. Both documents aim to assess health risks related to physical activity.
Consent to Treat Form: This form grants permission for medical professionals to provide care. Like the Sports Physical form, it requires signatures from guardians or parents, ensuring that they are informed about the athlete's health status.
Emergency Contact Form: This document lists individuals to contact in case of an emergency. It parallels the Sports Physical form by emphasizing the importance of having immediate access to relevant contact information.
Immunization Record: An immunization record outlines vaccinations an individual has received. Similar to the Sports Physical form, it is essential for ensuring the athlete's health and safety during participation in sports.
Health Insurance Information Form: This form collects details about an athlete's health insurance coverage. Like the Sports Physical form, it is crucial for managing potential medical expenses during sports activities.
Release of Liability Form: This document protects organizations from legal claims related to injuries. It shares similarities with the Sports Physical form by requiring acknowledgment of risks associated with physical activity.
Participation Agreement: A participation agreement outlines the terms and conditions for joining a sports team. It is similar to the Sports Physical form in that both require parental consent and acknowledgment of health-related issues.
Informed Consent Form: This form ensures that athletes understand the risks of participation. Like the Sports Physical form, it emphasizes the importance of being aware of health conditions before engaging in sports.
Return to Play Form: This document is used when an athlete is cleared to resume sports after an injury. It parallels the Sports Physical form by requiring a physician's assessment of the athlete's health status.

Dos and Don'ts

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

Do provide clear and accurate information for all sections of the form.
Do ensure that all contact information is up to date and correct.
Do answer all medical history questions honestly and thoroughly.
Do include any known medical alerts, such as allergies or chronic conditions.
Do have a parent or guardian review the form before submission.
Don’t leave any sections blank; incomplete forms may delay the process.
Don’t provide misleading information, as it could affect the athlete's health and safety.

By following these guidelines, you help ensure that the athlete receives the appropriate care and attention needed for their sports participation.

Misconceptions

Misconceptions about the Sports Physical form can lead to misunderstandings regarding its purpose and importance. Here are four common misconceptions:

The Sports Physical form is only a formality. Many people believe that the Sports Physical form is merely a bureaucratic requirement with little significance. In reality, this form plays a crucial role in assessing an athlete's health and identifying potential risks. It is an essential tool for ensuring the safety of young athletes during physical activities.
Only the physician's examination matters. Some assume that the physical examination conducted by a physician is the only important aspect of the Sports Physical. However, the information provided by athletes and their parents in the medical history section is equally vital. This self-reported data can highlight specific health concerns that might not be apparent during a brief examination.
All athletes are cleared to participate if they pass the physical. A common belief is that passing the physical examination guarantees that an athlete is fit to participate in all sports activities. This is not always the case. Participation restrictions may be necessary based on the athlete's medical history or current health conditions, and these should be clearly noted on the form.
Parents can fill out the form without any input from the athlete. Some parents think they can complete the Sports Physical form without involving their child. While parents can provide valuable information, it is essential for athletes to be actively engaged in this process. Their awareness of their own health conditions and concerns is crucial for accurate reporting.

Key takeaways

Filling out and using the Sports Physical form is an important process for ensuring an athlete's health and safety. Here are key takeaways to consider:

Complete all sections: Ensure that every part of the form is filled out accurately, including personal information and medical history.
Involve parents or guardians: Athletes under 18 should have their parents or guardians assist in completing the form, especially regarding medical history.
Be thorough with medical history: Answer all questions honestly. This information helps healthcare providers assess any potential risks.
Note any medical alerts: Clearly indicate any allergies or medical conditions that could affect the athlete's participation.
Schedule a physical examination: Make an appointment with a licensed medical professional to complete the physical exam section of the form.
Keep a copy: After the form is completed and signed, retain a copy for your records and provide one to the school or sports organization.
Update as necessary: If there are any changes in the athlete’s health or medical status, update the form accordingly before the next sports season.
Understand participation restrictions: If there are any limitations noted by the physician, ensure that all coaches and relevant personnel are informed.

Following these guidelines will help ensure that the Sports Physical form is filled out correctly and used effectively, prioritizing the athlete's health and safety.