 Preparticipation Physical Evaluation HISTORY FORM (Note: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep a copy of this form in the chart.) - Indiana High School Athletic Association - Document - PDFSEARCH.IO

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	 Preparticipation Physical Evaluation HISTORY FORM (Note: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep a copy of this form in the chart.) Add to Reading List Document Date: 2014-06-05 12:24:08 Open Document File Size: 467,02 KB Share Result on Facebook City Indianapolis / / Company Indiana High School Athletic Association Inc. / RELEASE CERTIFICATE Indiana High School Athletic Association Inc. / / Facility American College of Sports Medicine / / IndustryTerm football insurance / adequate family insurance coverage / g / Organization American College of Sports Medicine / Indiana High School Athletic Association / American Society for Sports Medicine / American Academy of Family Physicians / school board / American Academy of Pediatrics / state accrediting agency / File In office of the Principal Separate Form Required / American Orthopaedic Society for Sports Medicine / Sports Medicine / and American Osteopathic Academy of Sports Medicine / / Person D. E. F. G. Undersigned / / Position physician / representative / prospective post-secondary school student-athlete / student-athlete / ATTENTION ATHLETE / / ProvinceOrState Indiana / Marion County / / Technology Sports Medicine / / URL www.ihsaa.org / / SocialTag Indiana high school athletic conferences Education in Indiana Indiana High School Athletic Association Indiana

 Preparticipation Physical Evaluation HISTORY FORM (Note: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep a copy of this form in the chart.)Add to Reading List