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  1. As a minimum requirement, this Physical Examination Form must be completed prior to junior high participation and again prior to first and third years of high school participation. It must be completed if there are yes answers to specific questions on the student's MEDICAL HISTORY FORM on the reverse side.

  2. • As a minimum requirement, this Physical Examination Form must be completed prior to junior high athletic participation-and, again prior to first and third years of high school athletic participation.

  3. This form should be maintained by the healthcare provider completing the physical exam (medical home). It should not be shared with schools. The medical eligibility form is the only form that should be submitted to a school.

  4. As a minimum requirement, this Physical Examination Form must be completed prior to junior high athletic participation and again prior to first and third years of high school athletic participation. It must be completed if there are yes answers to specific questions on the student's MEDICAL HISTORY FOR on the reverse side.

  5. Ihave examined the above-named student and completed the preparticipation physical evaluation. The athlete does not present apparent clinical contraindications to practice and participate in the sport(s) as outlined above. A copy of the physical exam is on record in my office and can be made available to the school at the request of the parents.

  6. In keeping with the requirements of the Texas Association of Private and Parochial School, as a minimum requirement, this PHYSICAL EXAMINATION FORM must be completed prior to high school athletic participation each year of high school.

  7. Ihave examined the above-named student and completed the preparticipation physical evaluation. The athlete does not present apparent clinical contraindications to practice and participate in the sport(s) as outlined above. A copy of the physical exam is on record in my office and can be made available to the school at the request of the parents.

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