Interim COVID Forms
The purpose of the Medical History Form and Physical Evaluation Form is described below. Interim versions of these forms have been developed to incorporate questions about COVID-19 history and COVID-19 vaccination status. Athletes who have a current Preparticipation Physical Evaluation (per state and local guidance) on file will not need to complete another evaluation or history form.
Interim COVID Medical History Form Interim COVID Physical Evaluation Form
Medical History Forms
We encourage athletes or their families to fill out a medical history form before the examination that includes standard elements important to consider in evaluating the patient’s eligibility to participate in sports. The forms are available as downloadable forms in English and Spanish.
The primary care provider should review the medical history in a private setting with the athlete and their guardian and again in private with the athlete should there be any confidential information the athlete would like to discuss.
Physical Evaluation Form
The PPE physical evaluation form guides primary care providers in conducting a system-based examination to include cardiovascular, nervous system, general medical conditions, respiratory system, gastrointestinal and urogenital, dermatological, musculoskeletal and mental health.
When determining medical eligibility, the primary care provider should have experience in evaluating athletes and determining if they are medically able to compete. Examinations in locker rooms or gymnasiums are discouraged as it does not provide the athlete with a confidential space for the PPE.
After the examination, the primary care provider can find the athlete:
- medically eligible for sports without restrictions
- medically eligible for sports without restriction, but further evaluation needed
- medically eligible for certain sports listed on the form
- not medically eligible for any sports, pending further evaluation
- not medically eligible for any sports
The PPE writing group has developed a standard medical eligibility form.
A supplemental history form for Athletes with a Disability is also available. Please note this form should not be used in place of the Special Olympics form.
If the child is participating in the Special Olympics please use:
Special Olympics Medical Form Special Olympics Medical Form Instructions
Special Olympics Article 1 Sports Rules (appendix E)
More information: https://www.aap.org/en/patient-care/preparticipation-physical-evaluation