Transcription of Miami-Dade County Public Schools Division of …
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Miami-Dade County Public Schools Division of Athletics and Activities Athletic Physical Form Procedures Procedures for Completing M-DCPS Athletic Physical Form FM-3439 Rev. (03-17). Page 1. Please be sure to complete the following sections: o Section I - Student Information o Section II - Parent/Guardian Information o Section III - Parent/Guardian Insurance Information The physical will not be accepted as complete if any information is missing. Florida High school Athletic Association (FHSAA) Preparticipation Physical Evaluation EL2. Revised 03/16. Page 1. Complete Part 1, Student Information Complete Part 2, Medical History. Check Yes or No to the questions. If the student/parent answers "Yes" to any question, explain why or what at the bottom of page in section provided. Student signature and date required Parent/Guardian signature and date required Page 2. Part 3, Physical Examination, is to be completed by a licensed physician, licensed osteopathic physician, licensed chiropractic physician, licensed physician assistant, or certified registered nurse practitioner.
Miami-Dade County Public Schools Division of Athletics and Activities Athletic Physical Form Procedures Procedures for Completing M-DCPS Athletic Physical Form FM-3439 Rev. (05-18)
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