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Download Alabama High School Physical Template

The Alabama High School Physical Form is a critical document required for students wishing to participate in interscholastic athletics. This form serves as a comprehensive evaluation of a student's health, ensuring they are physically fit to engage in sports activities. Completing this form accurately helps protect the well-being of young athletes and ensures compliance with state regulations.

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Download Alabama High School Physical Template

Content Overview

The Alabama High School Physical form is an essential document for students wishing to participate in interscholastic athletics. This form serves multiple purposes, primarily ensuring that student-athletes are physically fit to engage in sports activities. It begins by gathering basic information about the student, including their name, age, address, school, and grade. The form also includes a comprehensive medical history section that prompts students to disclose any past injuries, medical conditions, or ongoing health issues. Questions cover a range of topics, from previous surgeries to allergies, and even menstrual history for female athletes. The physical examination section requires a licensed physician to assess the student’s overall health, including cardiovascular and musculoskeletal evaluations. The physician must then provide a clearance statement, indicating whether the student is fit to participate in athletic activities. This clearance is valid for one calendar year, emphasizing the importance of regular health assessments. Overall, the Alabama High School Physical form is designed to protect the health and safety of student-athletes while ensuring compliance with state athletic regulations.

Key takeaways

Filling out and using the Alabama High School Physical form is an important step for student-athletes. Here are some key takeaways to keep in mind:

Complete Personal Information: Ensure that all personal details, such as name, age, address, and school, are filled out accurately. This information is crucial for identification and record-keeping.
Medical History is Key: Take time to answer all medical history questions honestly. This includes any past injuries, surgeries, or ongoing health issues. Your responses help the physician assess your readiness for sports.
Physician's Role: A qualified physician must conduct the physical examination. This can be a Medical Doctor (M.D.) or a Doctor of Osteopathy (D.O.). Their evaluation is essential for determining your fitness to participate in athletics.
Validity of the Exam: The physical exam is valid for one calendar year from the date of the examination. Keep track of the expiration date to ensure eligibility for sports participation.
Clearance Categories: The physician will indicate your clearance status. This can be “cleared,” “cleared after completing evaluation/rehabilitation,” or “not cleared.” Understanding this status is vital for knowing your participation options.
Signatures Required: Both the athlete and a parent or guardian must sign the form. This confirms that the information provided is accurate and that you are aware of your health status.

Following these guidelines will help ensure a smooth process when preparing for athletic participation in Alabama high schools. Always keep a copy of the completed form for your records.

Guide to Writing Alabama High School Physical

Completing the Alabama High School Physical form is essential for student-athletes who wish to participate in sports. This form requires information about the athlete’s medical history and a physical examination by a licensed physician. Below are the steps to fill out the form accurately.

Gather Personal Information: Start by entering the athlete's name, sex, age, address, school, and grade on the form.
Medical History: Answer the questions regarding any past medical issues, injuries, or conditions. Be honest and thorough. If you answer "Yes" to any question, provide additional details in the space provided.
Menstrual History: For female athletes, indicate the date of the last menstrual period and any relevant details about menstrual cycles.
Physical Examination: Schedule an appointment with a physician. During the visit, the doctor will conduct a physical examination and fill out the necessary sections of the form.
Physician's Clearance: After the examination, the physician will indicate whether the athlete is cleared to participate in sports and note any restrictions if applicable.
Signatures: Ensure that both the athlete and a parent or guardian sign the form, confirming that the information provided is accurate.
Submit the Form: Finally, submit the completed form to the school's superintendent or principal's office. Keep a copy for your records if needed.

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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.)

Documents used along the form

The Alabama High School Physical form is essential for student-athletes, ensuring they are fit to participate in sports. However, several other documents often accompany this form to provide a comprehensive overview of a student's health and eligibility. Below is a list of these important forms.

Emergency Contact Form: This document lists emergency contacts for the athlete, ensuring that the school can reach someone in case of an emergency during practices or games.
Concussion Awareness Form: This form educates athletes and their parents about the risks of concussions and requires signatures to acknowledge understanding of the information provided.
Insurance Information Form: This document collects details about the athlete's health insurance coverage, ensuring that any medical expenses incurred during sports activities can be addressed.
Recommendation Letter Form: This form is essential for providing support for student-athletes seeking scholarships or college admission, as it allows coaches or teachers to endorse the athlete's skills and character, which can be submitted through platforms like smarttemplates.net.
Parental Consent Form: This form grants permission for the athlete to participate in sports, ensuring that parents are aware of the risks and responsibilities involved.
Sports Physical Examination Form: While similar to the Alabama High School Physical form, this document may be required by some schools or sports leagues and includes specific health assessments by a physician.
Health History Form: This form gathers detailed medical history, including past injuries and illnesses, to provide a clearer picture of the athlete's health status.
Participation Agreement: This document outlines the rules and expectations for athletes and their parents, ensuring everyone understands their commitments and responsibilities.

These forms work together to create a safer environment for student-athletes, helping schools manage health risks effectively. Ensuring that all necessary documents are completed and submitted can significantly contribute to a positive athletic experience.