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Free Sports Physical PDF Template

The Sports Physical Form serves as a comprehensive tool designed to assess the health and readiness of athletes before they participate in sports activities. It captures essential information such as personal details, medical history, and a physical examination to be completed by a licensed medical professional. This form plays a pivotal role in identifying any potential risks to the athlete's well-being and ensuring a safe sports participation experience.

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Outline

The journey of every athlete begins with not just training and skills development but also ensuring they are physically fit to participate in sports activities. The Sports Physical Form serves as a cornerstone in this process, providing a structured assessment of an athlete's health and medical history before they step onto the field or court. This comprehensive form captures essential information including personal details, emergency contact numbers, and medical alerts that might affect the athlete's ability to perform. It delves deeper with a medical history questionnaire designed for both athletes and their parents to complete, highlighting any potential risks such as sudden family deaths before age 50, episodes of dizziness during exercise, history of concussion, or any chronic illness. Moreover, the form encompasses a section for the physical examination conducted by a physician, concentrating on vital signs, vision, cardiovascular health, musculoskeletal condition, and more to certify the athlete's medical fitness. Such a detailed evaluation underlines the significance of this form in safeguarding the health and safety of athletes, anticipating any medical conditions that could potentially interrupt their sports career. Consequently, the Sports Physical Form is instrumental in not only promoting a safe sporting environment but also in fostering the well-being of athletes, establishing a fundamental prerequisite for their participation in sports activities.

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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: _________________________________________________________________

__________________________________________________________________________________________________

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Document Attributes

Fact	Detail
Form Objective	This form is designed to assess the health and physical condition of athletes before they participate in sports, to minimize the risk of injury.
Required Information	It collects personal information, medical history, and requires a physical exam to be completed by a medical professional.
Legal Necessity	Many states require sports physicals to be completed before students can participate in school-sponsored athletic programs.
Medical History Importance	The medical history section helps identify any conditions that might affect the athlete's ability to safely participate in sports.
Professional Examination Required	A licensed medical physician, physician's assistant, or family nurse practitioner must perform the physical exam. A Doctor of Chiropractic Medicine is not acceptable.
Frequency of Examination	Though it can vary by state, most require that the sports physicals are done annually.
Participation Restrictions	The examining professional can recommend restrictions or modifications to participation based on findings during the physical examination.

How to Fill Out Sports Physical

After scheduling a sports physical, the next step involves accurately completing the Sports Physical Form. This document is crucial for evaluating an athlete's medical suitability for participation in sports activities. The information provided helps medical professionals assess any potential risks that could affect the athlete's performance or well-being during sports activities. Completing the form thoroughly and honestly ensures the safety of the athlete and assists the examining physician in making well-informed decisions regarding the athlete's physical fitness for sports participation.

Start by entering the athlete's full name, selecting their gender (M for male, F for female), and filling in their Date of Birth in the designated format (month/day/year).
Provide parental information, including the names of the athlete's father and mother, alongside their respective daytime phone numbers, pagers, or cell phone numbers.
Input the home address of the athlete, including the street address, city, state, and zip code. Also, include the home phone number.
List an Alternate Emergency Contact Person outside of the immediate family, including their name and daytime phone number.
Under the MEDICAL ALERTS section, specify any critical medical alerts such as allergic reactions, the use of contact lenses, or other pertinent conditions that emergency responders should be aware of.
Complete the Medical History section by answering "YES," "NO," or "Don’t Know" to all questions regarding the athlete’s medical history, such as sudden family deaths before age 50, instances of dizziness or fainting during exercise, chronic illnesses, allergies, medication intake, and previous injuries or surgeries.
If any question in the Medical History section is answered with "YES," provide detailed explanations and specific information related to the "YES" responses in the space provided.
The PHYSICAL EXAM section should be left blank for completion by the examining physician. This section includes fields for height, weight, pulse, blood pressure, vision tests, and findings regarding various physical examinations ranging from eyes and ears to cardiovascular, chest, lungs, and neuromuscular aspects.
The physician will also mark down any participation restrictions based on the physical examination outcomes.
Ensure that the physician completes the bottom section of the form, including their initials, printed name or stamp, street address, city, state, zip code, telephone number, and signature with the date of examination.
Lastly, the physician will note any PARTICIPATION RESTRICTIONS for the athlete, if applicable, at the bottom of the form.

Ensure that all sections of the form are completed as accurately and thoroughly as possible to support the health and safety of the athlete. Completion of this form is a collaborative effort between the athlete, their guardians, and the examining medical professional.

More About Sports Physical

What is the purpose of the Sports Physical Form?

The Sports Physical Form is designed to assess the health and fitness of individuals looking to participate in sports activities. It helps in identifying any underlying medical conditions that might pose a risk during sports participation. Completing this form ensures that athletes are physically capable of engaging in their chosen sport, minimizing the risk of injury. The form collects detailed information about the athlete's medical history, family medical history, and current health status, which are essential for making informed decisions about their ability to safely participate in sports activities.
Who needs to complete the Sports Physical Form?

Both athletes and their parents or guardians need to jointly complete the Sports Physical Form. The initial section, which includes medical history and medical alerts, should be filled out by the athletes and their parents to provide a comprehensive health record. This collaboration ensures that all relevant health issues and medical history are accurately reported. Parents often contribute additional information or clarification about family medical history and previous health incidents that the athlete might not fully remember or know. After the initial sections are completed, a licensed medical professional must perform the physical examination and fill out the corresponding part of the form.
Why do physicians have to complete part of the form?

Physicians play a crucial role in the sports physical process by completing the physical exam section of the form. This part of the form requires medical expertise to accurately assess the athlete’s physical health, including vital signs, vision, cardiovascular health, musculoskeletal condition, and overall fitness for participation in sports. The evaluation can reveal health issues that might increase the risk of injury or that could be exacerbated by intense physical activity. A physician’s assessment ensures that any participation is safe and informed by a thorough medical examination. Licensed medical practitioners including physicians, physician's assistants, and family nurse practitioners are qualified to conduct this examination.
Can a Doctor of Chiropractic Medicine complete the Sports Physical Form?

No, a Doctor of Chiropractic Medicine cannot sign off on the Sports Physical Form. According to the instructions on the form, only licensed medical physicians, physician’s assistants, or family nurse practitioners are authorized to perform the physical examination and certify an athlete's fitness for sports participation. This requirement ensures that the individual conducting the examination has a broad medical knowledge base and the authority to address a wide range of health issues beyond the musculoskeletal system, which is the primary focus of chiropractic care.
What happens if an athlete answers "YES" to any question in the medical history section?

If an athlete answers "YES" to any question in the medical history section, it indicates a potential health issue that might influence their ability to safely participate in sports. The athlete is required to provide details about any affirmative answers, which helps the examining physician to understand the context and severity of the issue. Based on this information, the physician may recommend further evaluation, restrict participation, or suggest modifications to ensure the athlete’s safety. It’s important that these inquiries are addressed thoughtfully and thoroughly to safeguard the athlete's health and well-being during sport activities.

Common mistakes

Filling out a Sports Physical form is an important step in ensuring an athlete's safety and readiness for participation in sports activities. However, mistakes can be made during this process that might affect the accuracy and efficacy of the physical examination. Here are nine common mistakes to avoid:

Not providing complete information: Every field in the Sports Physical form is crucial for a comprehensive understanding of the athlete's health status. Skipping sections or leaving blanks can lead to oversight of potential health issues.
Incorrect medical history details: The medical history section is vital for identifying risks that could impact an athlete's safety during sports activities. Errors or inaccuracies in this section can mislead the examining physician.
Omitting information on medication or allergies: Forgetting to mention any medications the athlete is taking or allergies they have can lead to severe complications, especially if medication is prescribed based on the physical examination.
Failing to note previous injuries or surgeries: Not disclosing past injuries or surgeries may result in the physician not fully understanding the athlete's physical condition, potentially leading to re-injury.
Providing vague answers to questions about the athlete's health history: Vague or non-specific responses can hinder the physician's ability to assess the athlete’s readiness and safety for participation in sports.
Forgetting to update contact information: Updated contact information is essential, especially in the case of emergencies. It ensures that parents or guardians can be reached promptly.
Misidentifying the athlete’s gender or utilizing wrong identifiers: This can affect the relevance of certain medical evaluations and recommendations and might lead to an uncomfortable experience for the athlete.
Not clarifying participation restrictions: If there are any restrictions to the athlete’s participation based on previous medical advice, not specifying these can lead to harmful oversight.
Illegible handwriting: While this might seem minor, handwriting that is difficult to read can lead to misunderstandings or errors in the athlete's medical records and care recommendations.

To ensure the health and safety of the athlete, it is imperative to approach the Sports Physical form with thoroughness and accuracy. Parents, guardians, and athletes should work together to ensure all information is complete and accurate, providing the best foundation for a positive sports experience.

Documents used along the form

For athletes, completing a Sports Physical form is a crucial step in ensuring they are fit and ready to participate in sports activities. However, several other forms and documents often accompany the Sports Physical form to provide a comprehensive health and eligibility overview. These documents are important for safeguarding the athlete's well-being and ensuring they meet all necessary requirements for participation.

Emergency Medical Authorization Form: This form allows designated individuals to make medical decisions on the athlete's behalf in case of an emergency when the parents or guardians cannot be reached.
Concussion Acknowledgement Form: It educates and gathers acknowledgment from athletes and their parents or guardians about the risks of concussions during sports activities.
Athletic Code of Conduct: A document that outlines the expectations, behaviors, and rules athletes must follow, ensuring that all participants understand their responsibilities towards sportsmanship and team integrity.
Insurance Verification Form: This form confirms that the athlete has valid health insurance coverage, which is essential in covering medical treatments or injuries incurred during sports participation.
Liability Waiver/Release Form: A legal document where athletes and their parents or guardians acknowledge the risks involved in participating in sports and agree not to hold the school or organization liable for any injuries.
Medical History Form: Complements the Sports Physical form by providing detailed information about the athlete's medical history, ensuring that medical practitioners have all the necessary information for a comprehensive evaluation.
Medication Authorization Form: For athletes who need to take medication during school hours or sports activities, this form authorizes and provides instructions for administering medication.
Academic Eligibility Form: Confirms that the athlete meets the academic requirements set forth by the school or sports organization, emphasizing the importance of academic performance in athlete participation.

Together with the Sports Physical form, these documents create a framework that supports athlete safety, health, and well-being, ensuring that both the physical and administrative aspects of sports participation are adequately addressed. For athletes, parents, coaches, and sports administrators, familiarizing themselves with these documents and ensuring their timely completion and submission paves the way for a successful and injury-free sports season.

Similar forms

Annual Physical Examination Forms: Like the Sports Physical Form, Annual Physical Examination Forms are used to evaluate an individual's overall health status. Both require information on medical history, allergies, and a physical exam to assess fitness for activities.
Pre-Employment Health Screening Forms: These forms resemble Sports Physical Forms as they assess an individual’s physical capability to perform specific job duties safely. Both documents gather data on medical history and may include a physical examination by a healthcare provider.
Medical History Questionnaires: Similar to the Sports Physical Form, Medical History Questionnaires collect detailed information about an individual’s past and current health status, including family medical history, previous illnesses, surgeries, and ongoing conditions.
Medication Lists: Sports Physical Forms often include sections for listing medications, just like standalone Medication List forms. Both serve to inform healthcare providers or others about current medications that might affect an individual’s health or activity participation.
Consent Forms for Minor’s Medical Treatment: Like the Sports Physical Form, which often requires parental consent for minors, these consent forms authorize the provision of medical care. Both forms are necessary when legal guardians must approve health services for children.
Emergency Contact Information Forms: Sports Physical Forms and Emergency Contact Information Forms both collect essential contact information for use in urgent situations. This information is critical for reaching family members or designated contacts in case of an emergency.
Allergy Information Forms: Both the Sports Physical Form and Allergy Information Forms contain sections for documenting allergic reactions, which is crucial for developing safe participation plans in sports, activities, or environments that might trigger reactions.
School Entrance Health Forms: Similar to Sports Physical Forms, School Entrance Health Forms assess children's health and immunization status to ensure they are fit to enter school. Both forms often require a physician’s examination and certification of fitness for participation.
Camp Physical Forms: Much like Sports Physical Forms, Camp Physical Forms are used to evaluate a child’s fitness for camp activities. They include health history, examination results, and sometimes immunization records to ensure a safe camp experience.
Immunization Records: While Sports Physical Forms address a broader set of health questions, they share similarities with Immunization Records through the documentation of vaccines. Both forms can play a crucial role in determining eligibility for participation in sports or school activities based on health protection and prevention of disease spread.

Dos and Don'ts

When filling out a Sports Physical form, it's crucial to approach it with care and attention to detail. This document plays a significant role in ensuring the safety and well-being of athletes. To guide you through this process, here are things you should and shouldn't do.

Things You Should Do:

Provide Complete and Accurate Information: Ensure that every required field is filled out with current and accurate information. This includes personal details, medical history, and contact information.
Disclose All Medical Conditions and Allergies: Be transparent about any medical conditions, allergies, or previous sports-related injuries. This information is crucial for assessing fitness to participate in sports activities safely.
Review Medical History Questions Carefully: Take your time to go through each question on the medical history section. Answering these questions truthfully helps in identifying any potential risks that need to be addressed.
Seek Clarification When Needed: If there are any questions or sections that are unclear, don't hesitate to ask for clarification. It's better to seek help than to submit incomplete or inaccurate information.

Things You Shouldn't Do:

Don't Leave Any Section Unanswered: Skipping questions or leaving sections blank can lead to incomplete health assessments. If a question doesn't apply, fill it with "N/A" (Not Applicable) instead of leaving it blank.
Don't Guess on Medical History: If you're unsure about a particular medical history detail, consult previous medical records or your healthcare provider rather than making a guess.
Avoid Using Nicknames or Incomplete Names: Use the athlete's full legal name as it appears on official documents. Nicknames or abbreviated names can cause confusion and documentation errors.
Refrain From Rushing Through the Form: Filling out the form in a hurry can lead to mistakes or omissions. Take your time to ensure that every detail is covered accurately.

Misconceptions

There are several misconceptions about the sports physical form that need to be clarified. These misunderstandings can affect how parents and athletes approach sports participation.

Only relevant for school sports: Many believe the sports physical form is only necessary for school sports. However, this form is also important for community sports leagues and camps that require a health overview before participation.
Substitutes for an annual check-up: Another misconception is that a sports physical can replace an annual health check-up. A sports physical focuses on an athlete’s ability to participate in sports and may not cover other health aspects an annual check-up would.
Once completed, valid for all sports: People often think one sports physical form is sufficient for participation in any sport within the same year. However, each sport might have its specific requirements and risks. Some programs may request an updated form for each sport season.
Only the physical examination matters: There's a common belief that only the physical exam section of the form matters. In truth, the medical history section is equally important as it helps identify risk factors that might not be evident during the physical exam.
Any doctor can sign off on the form: Finally, there is a misconception that any type of doctor can complete and sign the sports physical form. In reality, the form specifies that the individual must be a licensed medical physician, physician's assistant, or a family nurse practitioner. Doctors of Chiropractic Medicine, for example, are not acceptable signatories for this form.

Clarifying these misconceptions ensures athletes and parents approach sports participation with all necessary information, promoting health and safety in sports activities.

Key takeaways

Understanding the Sports Physical Form is vital for ensuring athlete safety and readiness for participation. Here are key takeaways to consider:

Accuracy is key: When filling out the form, it's crucial to provide accurate and up-to-date information. This helps medical professionals assess the athlete’s eligibility and identify any potential health risks.
Medical history matters: The medical history section is essential in determining the athlete's readiness and risk factors. Answer each question truthfully, as this information could prevent injuries or other medical emergencies.
Update medical alerts: Always update the medical alerts section with any new allergies, conditions, or medical needs. This includes anything from contact lenses to critical allergic reactions.
Family history: Sudden deaths in the family before the age of 50 may indicate underlying conditions that could affect the athlete. Be thorough and honest in this section.
Provide detailed responses for “YES” answers: Any question answered with "YES" requires a detailed explanation. This helps the physician understand the context and severity of the issue.
Physical examination by a qualified professional: The physical exam section must be completed by a licensed medical physician, physician's assistant, or family nurse practitioner. Chiropractors are not accepted.
Understand participation restrictions: The physician may list restrictions based on the physical examination. It's important to understand and adhere to these restrictions for the athlete's safety.
Keep the form accessible: Once completed, ensure the sports physical form is easily accessible and kept on file with the relevant school or sporting organization. It may need to be referred to in case of a medical emergency or queried by officials.

By carefully completing and utilizing the Sports Physical Form, athletes, parents, and educators can work together to promote safe participation in sports activities. Remember, the primary goal is to safeguard the health and well-being of the athlete, making the form a critical tool in achieving this objective.

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