
RINGGOLD
SCHOOL DISTRICT SPORTS PHYSICALS
SPORT
PARTICIPATION ATHLETIC PHYSICAL FORMS
are available in the Health office and
must be submitted to the HEALTH OFFICE if
the athlete intends to participate in
school sports. To schedule a school physical with the
school physician the form must be submitted by the date
announced for each
sport season.
The following are NEW PIAA (Pennsylvania
Interscholastic Athletic Association) requirements for
sports eligibility: Physical must take place
AFTER
June 1
This form allows the athlete to participate in the fall,
winter, and spring seasons with just one physical unless
he/she was injured or ill during the previous season.
SECTION 1- PERSONAL AND EMERGENCY INFORMATION
-
All parts must be answered
SECTION 2 - CERTIFICATION OF PARENT/GUARDIAN
-
Parts A, B, C, D, and E must be signed by parent or
guardian.
-
In the box area, parent or guardian signature should
be beside each sport the student-athlete plans on
playing during the 2008-09 school year.
SECTION 3 - HEALTH HISTORY
-
Questions 1 thru 46 for all student-athletes should be
marked yes or no. Female student-athletes also answer
47 thru 50.
-
All "YES" answers need explained in the box at the
bottom of the page.
-
Student and parent! guardian signatures are needed.
THE ABOVE 3 SECTIONS MUST BE COMPLETED BEFORE A PHYSICAL
WILL BE GIVEN.
SECTION
4 - PIAA COMPREHENSIVE INITIAL PRE-PARTICIPA TION
EVALUATION & CERTIFICATION OF AUTHORIZED MEDICAL
EXAMINER
-
The only part you need to fill in is name, age, grade,
school, and sports.
-
The doctor will fill in the rest of this page
SECTION 5 - (NEXT SPORT SEASON - within 6 weeks from
first day of practice)
RE-CERTIFICATION BY PARENT/GUARDIAN
-
The Supplemental Health History needs an update.
-
Questions-1 thru 9 need answered yes or no.
-
All "YES" answers need explained in the box at the
bottom of the page.
-
Student and parent/ guardian signatures are needed.
For the next sport, if you obtained an athletic physical
from your own private physician then you must contact
that office to get information on the procedure and FEE
for the medical clearance/re-certification.
RINGGOLD SCHOOL DISTRICT SPORTS SCHOOL
PHYSICAL/RE-CERTIFICATION DATES
WILL
BE ANNOUNCED 6 WEEKS PRIOR TO THE START OF EACH SPORT
SEASON. (FALL, WINTER, SPRING).
THESE ARE
THE ONLY DATES THE SCHOOL DOCTOR
WILL BE AVAILABLE. YOU ARE RESPONSIBLE
FOR OBTAINING YOUR OWN PRIVATE PHYSICAL IF YOU ARE
UNABLE TO BE SCHEDULED FOR A SCHOOL PHYSICAL
PHYSICALS PRIOR TO 6 WEEKS BEFORE THE
OFFICIAL PIAA START DATE FOR EACH SEASON
CAN NOT BE ACCEPTED

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