Nchsaa Sports Physical Form

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Nchsaa Sports Physical Form - Physical Examination Must be Completed by a Licensed Physician Nurse Practitioner or Physician s Assistant This form approved by the North Carolina High School Athletic Association Sports Medicine Advisory Committee December 2009 and the NCHSAA Board of Directors reviewed annually

The completed and signed PPE History Form must then be presented to the examining Licensed Medical Professional LMP physician licensed to practice medicine MD DO nurse practitioner or physician assistant for review when they fill out the Physical Examination Form

Nchsaa Sports Physical Form

Nchsaa Sports Physical Form

Nchsaa Sports Physical Form

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PHYSICAL EXAMINATION FORM Name Date of birth PHYSICIAN REMINDERS 1 Do you feel stressed out or under a lot of pressure a Consider electrocardiography ECG echocardiography referral to a cardiologist for abnormal cardiac history or examination findings or a combi nation of those Name of health care professional print or type

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Physical Examination Must be Completed by a Licensed Physician Nurse Practitioner or Physician Assistant This form is approved by the North Carolina High School Athletic Association Sports Medicine Advisory Committee and the NCHSAA Board of Directors This form is reviewed annually and was last updated April 2013 Title

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Nchsaa Sports Physical Form

North Carolina High School Athletic Association Sport Preparticipation

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Physical Examination Must be Completed by a Licensed Physician Nurse Practitioner or Physician s Assistant This form approved by the North Carolina High School Athletic Association Sports Medicine Advisory Committee March 2011 and the NCHSAA Board of Directors reviewed annually

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NCHSAA SCHOOL PHYSICAL FORM NCHSAA Instructions for Completing the NCHSAA Student Athlete Preparticipation Physical Evaluation PPE In order to be medically eligible for participation in practice or in interscholastic athletic contests a student must have a completed NCHSAA PPE and submit it to the school

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Nchsaa Sports Physical Form

Physical Examination Must be Completed by a Licensed Physician Nurse Practitioner or Physician s Assistant This form approved by the North Carolina High School Athletic Association Sports Medicine Advisory Committee March 2011 and the NCHSAA Board of Directors reviewed annually

The completed and signed PPE History Form must then be presented to the examining Licensed Medical Professional LMP physician licensed to practice medicine MD DO nurse practitioner or physician assistant for review when they fill out the Physical Examination Form

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