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Free Sports Physical PDF Form

The Sports Physical Form is a crucial document that assesses an athlete's health and readiness for participation in sports activities. It collects essential information about the athlete's medical history, family health background, and any existing health conditions. Ensuring this form is accurately completed and submitted is vital for the safety and well-being of young athletes.

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Outline

Before an athlete can step onto the field or court, a critical step must be taken: the completion of the Sports Physical form. This essential document collects vital information about the athlete's health, ensuring their safety and readiness for participation in sports. Key details such as the athlete's name, gender, and date of birth are recorded at the outset, followed by contact information for parents or guardians. The form also emphasizes the importance of noting any medical alerts, such as allergies or existing health conditions, which could impact athletic performance or safety. A thorough medical history section follows, where both athletes and their families must answer questions regarding past injuries, chronic illnesses, and family health history. This section serves as a valuable tool for assessing potential risks associated with sports participation. Lastly, the physical examination conducted by a licensed medical professional is documented, providing insights into the athlete's physical condition, including height, weight, and vital signs, as well as an assessment of various bodily systems. The physician's certification at the end of the form indicates that the athlete is medically qualified to engage in sports, while also allowing for any necessary participation restrictions. Thus, the Sports Physical form plays an indispensable role in safeguarding the health and well-being of young athletes.

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Key takeaways

Complete all sections of the Sports Physical form. Ensure that all personal information, including names and contact details, is filled out accurately.
Provide honest answers to the medical history questions. This information helps assess the athlete's health risks and ensures safety during sports activities.
Consult with a physician for the physical examination. The physician will complete the physical exam section, which is essential for participation.
Be aware of medical alerts. If the athlete has allergies or other conditions, list them clearly on the form.
Keep a copy of the completed form. This can be useful for future reference or if the athlete needs to provide proof of their physical examination.
Check for participation restrictions. If the physician notes any limitations, make sure these are communicated to coaches and relevant staff.
Submit the form by the deadline. Many schools and sports organizations require this form before the athlete can participate in practices or games.

Form Preview Example

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: _________________________________________________________________

__________________________________________________________________________________________________