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PHYSICAL/ATHLETIC PHYSICAL EXAMINATION

MIDDLE AND HIGH SCHOOL PHYSICAL / athletic PHYSICAL EXAMINATION ARTICLE VII (1) PHYSICAL EXAMINATION . Every year each student shall present to the student s superintendent a certificate signed by a licensed physician and surgeon, osteopathic physician and surgeon, osteopath, advanced registered nurse practitioner (ARNP), physician assistant or qualified doctor of chiropractic, to the effect that the student has been examined and may safely engage in athletic competition or participate in PHYSICAL education programs. This certificate of PHYSICAL EXAMINATION is valid for the purposes of this rule for one (1) calendar year. A grace period, not to exceed thirty (30) days, is allowed for expired certifications of PHYSICAL EXAMINATION . Name _____Male _____ Female _____ Birth Date _____ Grade _____ School _____Home Address _____ Zip Code_____Phone # _____ HEALTH HISTORY: YES NO Has this student had any?

MIDDLE AND HIGH SCHOOL PHYSICAL/ATHLETIC PHYSICAL EXAMINATION ARTICLE VII 36.14 (1) PHYSICAL EXAMINATION.Every year each student shall …

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