2020 -21 IHSAA Physical Form and Information

Returning Athletes:

Any athlete with a 2019-2020 physical on file with the school must have a 2020-2021 Health History Update Questionnaire and Consent and Release form signed and on file with the school. 2020-2021 Pre Participation Release. This may be turned in the first day of workouts.

First Time Athletes:

The IHSAA Pre-participation Physical Evaluation (PPE) is the first and most important step in providing for the well-being of Indiana’s high school athletes. The form is designed to identify risk factors prior to athletic participation by way of a thorough medical history and physical examination. The IHSAA, under the guidance of the Indiana State Medical Association’s Committee on Sports Medicine, requires that the PPE Form be signed by a physician (MD or DO) holding an unlimited license to practice medicine, a nurse practitioner (NP) or a physician assistant (PA). In order to assure that these rigorous standards are met, both organizations endorse the following requirements for completion of the PPE Form:

2020-2021 IHSAA Physical

1. The most current version of the IHSAA PPE Form must be used and may not be altered or modified in any way.

2. The PPE Form must be signed by a physician (MD or DO) holding an unlimited license to practice medicine, a nurse practitioner (NP) or a physician assistant (PA) only after the medical history is reviewed, the examination performed, and the PPE Form completed in its entirety. No pre-signed or pre-stamped forms will be accepted.

3. SIGNATURES

The signature must be hand-written. No signature stamps will be accepted.

The signature and license number must be affixed on page two

The parent signatures must be affixed to the form on pages one (1) and four (4).

The student-athlete signature must be affixed to pages one (1) and four (4).

Your cooperation will help ensure the best medical screening for Indiana’s high school athletes.