Athletic Forms

Click here to access the Physical Forms to be completed and turned in. 

 

There are FOUR sections that need to be MUST be completed prior to participating...

 

1. History Form - pages 1 - 2 of form attached above (Printed, signed)

• a. This form is completed by the student-athlete and his / her parents or guardian.

• b. Both the athlete and a parent or guardian should sign this form.

 

2. Physical Examination Form - page 3 of form attached above

• a. This section is completed by and signed by a licensed medical professional (MD, DO, NP, or PA-C).

• b. The physical exam should include a thorough review of the history form. The licensed medical professional should ask any clarifying questions or discuss any areas left blank in the medical history during the physical exam.

• c. This form should be signed on the date that the physical examination was completed. 

 

3. Medical Eligibility. - page 4 of form attached above

• a. This section is completed, SIGNED & STAMPED by the licensed medical professional who reviewed the history form and completed the physical exam. 

• b. The licensed medical provider should complete the Shared Emergency Information based on findings from the history form and the physical examination. 

• c. This form should also be signed on the date that the physical examination is completed.

 

4. NCHSAA Gfeller-Waller Student-Athlete & Parent/Legal Custodian Concussion Information Sheet (Printed, signed)

• Click here to access Concussion Information Sheet.