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Generic Sports Physical Form

WEST VIRGINIA SECONDARY SCHOOL ACTIVITIES COMMISSION ATHLETIC ...

I also understand that participation in any of those sports listed above may cause permanent disability or death. Please check ... Physical Form Created Date:

Ohio High School Athletic Association Preparticipation ...

Has a doctor ever denied or restricted you participation in sports for any reason? ... Equal _____ Unequal _____ Physical Examination Form The section below is to be completed by physician or staff after history and consent forms are completed. MEDICAL ...

Preparticipation Physical EvaluationForm

Has a doctor ever restricted/denied your participation in sports? 2. ... _____ Date ____ Signature of parent/guardian _____ DUPLICATE AS NEEDED 2010 FORM 5 Page 1 of 2. Preparticipation Physical Evaluation Physical Examination Rule —In ... A physical will requirement for from Clearance: ...

USE THIS FORM FOR INITIAL PHYSICAL EXAM

Health Examination Form A, Updated September 2011 FORM A . USE THIS FORM FOR INITIAL PHYSICAL EXAM Instructions for use of pre-participation ... a medical illness or injury since your last check-up or ÖÖ devices that aren't usually used for your sport or position sports physical?

PRE-PARTICIPATION HISTORY & PHYSICAL EXAM

PRE-PARTICIPATION SPORTS PHYSICAL EXAM Vision: L20/ R20/ Both Corrected: Y N BMI_____ Height Weight Pulse B/P (R arm) Medical Normal Abnormal Findings ...

Examination and Medical History Forms

Page One (this page) - Instructions for completing the Physical Examination form, and should be read carefully by both the examini ng physician and the applicant.

Children's Physical Form

Children's Physical Form Name of Child Age Birth Date Name of Parent/Guardian Address of Parent/Guardian (Street) (City) (State) (Zip) A. MEDICAL HISTORY (May be ...

MUSCULOSKELETAL NORMAL ABNORMAL FINDINGS INITIALS

MEDICAL HISTORY FORM ... or sports physical? 2. Do you have an ongoing or chronic illness? 3. Have you ever been hospitalized overnight? 4. Are you ...

2010 PHYSICAL FITNESS & MEDICAL HISTORY FORM

Pop Warner Little Scholars, Inc. 2010 PHYSICAL FITNESS & MEDICAL HISTORY FORM 3/13/2010 Special Note: This form must be dated after January 1, 2010 and then submitted to your LOCAL Pop Warner organization.

Physical Form

Physical Form Doctor's Name: ... _____ I certify that I have examined this athlete and found him/her medically qualified to participate in sports. I also ...