Transcription of Normal Abnormal Findings Initials - aiaonline.org
1 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 (Print/Type): _____ Exam Date: _____Address: _____ Phone: _____Signature of Physician.
2 _____, MD/DO/ND/NMD/NP/PA-C/CCSPFORM 01/14/2019 (rev.) NextCare is the preferred partner of the AIA. It is not required you visit NextCare locations for your healthcare Junction 851202080 West Southern Ave., Suite #A1 Broadway RoadMeridian RoadIronwood DriveSouthern Avenue60 WalgreensAvondale 8539213075 W. McDowell Rd., Suite #D106W. McDowell Van Buren Indian School Dysart Litch eld sCasa Grande 851221683 E. Florence Blvd., Suite #710E. Florence Cottonwood Arizola Verbena Henness StoreBank ofAmericaWalmartChandler 85224600 S. Dobson Road, Suite #C-26 Chandler 852481155 W. Ocotillo Road, Suite #4 Pecos RoadDobson RoadFrye RoadChandler Ocotillo RoadS.
3 Alma School RdOcotillo VillageHealth ClubHolidayInnCoconut sFish Caf NextCare UrgentCareGlendale 853065410 W. Thunderbird Road, Suite #101W. Greenway RdN. 59th AveN. 51st AveN. 43rd AveW. Thunderbird RdASU West CampusThunderbird Paseo ParkN. 35th Ave17N. 55th AveHGlendale 853059494 W. Northern Ave., Suite #101 Peoria/Glendale9494 W. Northern Olive Northern 99th 91st Glendale 852051066 N. Power Road, Suite #101E. Brown RdRed MountainHigh SchoolN. Power Rd202N. Recker RdE. McKellips RdMesa 852043130 E. Baseline Road, Suite #10560 Baseline RoadN. Lindsay Val Vista 32nd ParkMesa 85203535 E. McKellips Road, Suite #101 McKellips Mesa HorneLOOP202 WalmartCottonwood 86326450 S.
4 Willard Street, Suite #12089AS. Calvary WayS. Willard Cottonwood 8530210240 N. 43rd Ave., Suite #310240 North 43rd Avenue, Ste #3 Glendale, AZ 85302W. Cactus 51st 43rd Dunlap 8530818589 N. 59th Ave., Suite #101 Goodyear 8533817688 W. Elliot RoadN. 59th AveW. Union Hills DrHoneywell101N. 51st AveN. 67th AveStarbucksW. Elliot RdSan GabrielMcDonald sSafewayStarpointe Resident ClubFlagstaff 86001399 S. Malpais Lane, Suite #100 Gilbert 852986343 S. Higley RoadDairy QueenBarnes& Noble40S Malpais LaneS Milton RdW Clay AveW Butler AveNorthernArizonaUniversityNatural GrocersWalgreensChase BankChevronE. Chandler Heights RdS. Higley RdFlagstaff 860011000 N.
5 Humphreys St., Suite #104180180N. Fort Valley RoadN. Humphreys StreetW. Columbus AvenueW. Desilva AvenueBasha sN. Beaver StreetFlagstaff MedicalCenterLake Havasu City 864031810 Mesquite Ave., Suite BKmart95 Mesquite McCulloch BlvdCapri LnCivic Center LnSwanson RegionalMedical Center95 Nogales 85621298 W. Mariposa RoadWashingtonFederalJcPenneyW. Mariposa RoadN. Mastick WayN. Grand 1-888-705-8562 Visit website for additional locations & hoursPeoria 8538220470 N. Lake Pleasant Rd., Suite #102 Rose Garden Pleasant Road(99th Ave.)(91st Ave.)10120470 N. Lake Pleasant 102 Peoria, AZ 85382 LakePleasantPkwyBashasWalgreensPhoenix 8505020950 N.
6 Tatum Blvd., Suite #19020950 N Tatum Blvd, Suite 190, Phoenix, AZ 85050E. Deer Valley Tatum Rose Garden RIDGEMARKET PLACE101101 Scottsdale 852607425 E. Shea Blvd., Suite #108N. Scottsdale RdE. Shea BlvdHarkins TheatersN. Hayden RdE. Mountain View RdN. 70th St101N. 74th StSun City 853519745 W. Bell Road, Suite #1059745 W. Bell Road, Suite 105 Sun City, 85351 W. Union Hills Bell 99th AveN. 98th 91st Thunderbird 857131570 E. Tucson Marketplace Ajo WayS. Kino ParkwayS. Park Avenue10E. Tucson Marketplace &BustersTucson 857126238 E. Pima StreetPimaSpeedwayWilmot106238 E. Pima St. TucsonCircle KTucson 857054280 North Oracle Rd., Suite #100W.
7 Wetmore Prince Miracle MileN. Oracle Flowing Wells N. Oracle Rd. Ste. 100 Tucson, AZ 8570577 WalgreensW. Limberlast 857065369 S. Calle Santa Cruz, Suite #145W. Ajo WayW. Valencia Drexel Irvington Midvale Park Calle Santa Cruz S. Calle Santa Cruz Suite 145, Tucson, 85706 Harkins19 Tucson 85719501 North Park Ave., Suite #110E. 6th Euclid Park N. Park Ave., Ste. 110 MetroWildcatSedona 863362530 W. SR 89A, Suite #AScottsdale 852572122 N. Scottsdale Road89 AyaW noreH tacraeB ybgiRAndante Calvary WayCOTTONWOODPRESCOTTPRESCOTT VALLEY89A89 AGreen Valley Creek Glassford Hill Navajo Robert Windsong S. Willard Street, Suite 120 Cottonwood, AZ 86326(Arizona 89A at Willard Street)2530 W.
8 SR 89 ASedona, AZ 86336(Arizona 89A & Andante Dr.)2062 Willow Creek , AZ 86301(Green Ln. & Willow Creek Rd.)3051 N. Windsong Valley, AZ 86314(E. Florentine Rd & Windsong Dr.)69E. Florentine Scottsdale RdE Oak StE Palm LnN 71st StBei Sushi BarDairyQueenGoodwillPrescott 863012062 Willow Creek Calvary WayCOTTONWOODPRESCOTTPRESCOTT VALLEY89A89 AGreen Valley Creek Glassford Hill Navajo Robert Windsong S. Willard Street, Suite 120 Cottonwood, AZ 86326(Arizona 89A at Willard Street)2530 W. SR 89 ASedona, AZ 86336(Arizona 89A & Andante Dr.)2062 Willow Creek , AZ 86301(Green Ln. & Willow Creek Rd.)3051 N. Windsong Valley, AZ 86314(E. Florentine Rd & Windsong Dr.)
9 69E. Florentine Valley 863143051 N. Windsong DriveN. Windsong Robert Florentine Lakeshore 850323229 E. Greenway Rd., Suite #102 Phoenix 850183931 E. Camelback Road51E. Thunderbird Bell 32nd 40th CitySushiholicCVSE. Elm Canal TrailE. Camelback 40th VillaApartmentsPhoenix 850355920 W. McDowell RoadW. McDowell Coronado 59th W. McDowell Rd, Phoenix, AZ 850357-11 WalgreensSurprise 8537414800 W. Mtn. View Blvd., Suite #10060N. Reems RdW. Mountain View BlvdHampton Inn & SuitesAlbertson sMarketW. Grand AveColonnade WayBanner Del E. WebbMedical CenterW. Bell Rd303 Phoenix 850161701 E. Thomas Road, Suite #A10451E. Oak Thomas Osborn 16th 21st 20 th sHospitalPhoenix 850184730 E.
10 Indian School Rd., Suite #211N. Arcadia SchoolN. 44th 850218101 N. 19th Ave., Suite #A8101 N. 19th Avenue, Ste. A Phoenix, AZ 85021W. Northern Orangewood 19th 7th 1-888-705-8562 Visit website for additional locations & hoursTempe 85281914 N. Scottsdale Rd., Suite #104 Curry RoadScottsdale RoadLOOP202 Jack inthe BoxRuralTucson 857489525 E. Old Spanish Trail, Suite #101 Yuma 853641394 W. 16th StreetE. Old Spanish TrailE 22nd StS Harrison Rd9525 E. Old Spanish Trail TucsonTargetStarbucksW. 8th StreetS. Avenue BS. Avenue Canal RoadS. 14th Avenue W. 16th Street8S. 4th 1-888-705-8562 Visit website for additional locations & hours
