Transcription of Normal Abnormal Findings Initials - aiaonline.org
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Normal Abnormal Findings Initials - aiaonline.org
ARIZONA INTERSCHOLASTIC ASSOCIATION7007 N. 18TH ST., PHOENIX, ARIZONA 85020-5552 PHONE: (602) 385-3810 The Preferred Urgent Care of the Arizona Interscholastic Association2020-21 ANNUAL PREPARTICIPATION PHYSICAL EXAMINATIONName: _____ Date of Birth: _____ Age: _____ Sex: _____ Height: _____ Weight: _____% Body Fat (optional): _____ Pulse: _____ BP: ____ / ____ (____ / ____,____ / ____)Vision: R20/____ L20/____ Corrected: Y NPupils:EqualUnequalNormalAbnormal FindingsInitials *MedicalAppearanceEyes/Ears/Throat/NoseH earingLymph NodesHeartMurmursPulsesLungsAbdomenGenit ourinary &SkinMusculoskeletalNeckBackShoulder/Arm Elbow/ForearmWrist/Hands/FingersHip/Thig hKneeLeg/AnkleFoot/Toes* - Multi-examiner set-up only& - Having a third party present is recommended for the genitourinary examinationNOTES:Cleared Without RestrictionCleared With Following Restriction: _____Not Cleared For: All Sports Certain Sports: _____ Reason: _____Recommendations: _____Name of Physician (Pr)
* - Multi-examiner set-up only & - Having a third party present is recommended for the genitourinary examination
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