• 2021-22 Annual Pre-Participation Physical Evaluation

    AIA 2021-2022 PHYSICAL FORMS

     

    15.7 PHYSICAL EXAMINATION RULE

    15.7.1 A student shall not be allowed to practice or compete in interscholastic athletics until there is on file with the principal or his/her designee a record of a preparticipation physical examination (PPE) performed by a doctor of medicine (M.D.), an osteopathic physician (D.O.), a naturopathic physician (N.D., N.M.D.), a certified registered nurse practitioner (N.P.) licensed to practice, a certified physician's assistant (PA-C) registered by the Joint Board Of Medical Examiners and the Osteopathic Examiners in Medicine and Surgery, or a certified chiropractic sports physician (CCSP).

    The physical examination for the following school year shall be given on or after March 1. The physical examination on file shall be signed by one of the aforementioned medical providers and shall state that, in the opinion of the examining provider, the provider did not find any medical reason to disqualify the student from practice or competition in athletic contests. The principal or his/her designee, if deemed advisable, may require a student to be reexamined.

    15.7.2 Member schools shall utilize the physical examination forms provided by the AIA. There shall be four parts:

    • 15.7.2.1 Part One – Annual Preparticipation Physical Evaluation – To be completed and signed by the parent or guardian and student athlete. This form must also be signed by the examining medical provider. (See Form 15.7-A).
    • 15.7.2.2 Part Two – Annual Preparticipation Physical Examination – To be completed and signed by the examining medical provider. (See Form 15.7-B).

    NOTE: The 2019-2020 sports physical shall be accepted for the 2020-2021 school year if the following criteria are met over the time period since the athletes 2019-2020 sports physical. a. Athlete has a 2019-2020 AIA sports physical on file with the school he/she is attending for 2020-2021. b. Athlete did not have any new injury or illness requiring outside medical evaluation or if injury did occur, was released for full athletic participation by a qualified medical professional. c. Athlete did not have a concussion d. Athlete did not receive a new medical diagnosis e. Athlete has not had COVID -19 1. Athlete must see his/her primary care provider and have an updated sports physical for 2020-2021 if any of the above criteria are not met. 2. If athlete does not have a 2019-2020 sports physical form on file at the school he/she is attending for the 2020-2021 school year, the athlete will also need to complete a 2020-2021 sports physical. 3. 2020-2021 Health History (15.7-A, page 3) is to be completed and signed by student and parent/guardian.

    • 15.7.2.3 Part Three – Annual Preparticipation Acknowledgement – To be completed and signed by parent or guardian and student athlete. (See Form 15.7-C).
    • 15.7.2.4 Part Four – Annual Preparticipation Consent to Treat Form – to be completed and signed by the parent or guardian and student athlete (See Form 15.7-D).