State of il sports physical form: free download. On-line document store on 5y1.org

[PDF File]FOR USE IN DCFS LICENSED CHILD CARE ... .us
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State of Illinois Certificate of Child Health Examination IL444-4737 (R-02-13) ... PHYSICAL EXAMINATION REQUIREMENTS Entire section below to be completed by MD/DO/APN/PA . ... LimitedINTERSCHOLASTIC SPORTS ...
2019 illinois sports physical form

[PDF File]SPORTS QUALIFYING PHYSICAL EXAMINATION
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I have examined the student named on this form and completed the Sports Qualifying Physical Exam as required by the Minnesota State High School League. The athlete does not have apparent clinical contraindications to practice and participate in the sport(s) as outlined on this form. A copy of the
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[PDF File]Pre-participation Examination
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Address City/State HISTORY FORM Medicines and ... American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports ... Pre-participation Examination PHYSICAL EXAMINATION FORM …
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[PDF File]State of Illinois Certificate of Child Health Examination
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State of Illinois Certificate of Child Health Examination ... PHYSICAL EXAMINATION REQUIREMENTS Entire section below to be completed by MD/DO/APN/PA ... Yes PHYSICAL EDUCATION No No Modified Modified INTERSCHOLASTIC SPORTS Yes Print Name (MD,DO, APN, PA) Signature Date ...
ihsa sports physical form 2019

[PDF File]PREPARTICIPATION PHYSICAL EVALUATION -- MEDICAL …
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PREPARTICIPATION PHYSICAL EVALUATION -- MEDICAL HISTORY REVISED 12-4-14 This MEDICAL HISTORY FORM must be completed annually by parent (or guardian) and student in order for the student to participate in athletic activities.These questions are designed to determine if the student has developed any condition which would make it hazardous to participate in an athletic event.
printable sports physical form 2019

[PDF File]State of Illinois Certificate of Child Health Examination
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State of Illinois Certificate of Child Health Examination ... PHYSICAL EXAMINATION REQUIREMENTS Entire section below to be completed by MD/DO/APN/PA . HEAD CIRCUMFERENCE if < 2-3 years old HEIGHT WEIGHT BMI BMI PERCENTILE B/P . DIABETES SCREENING (NOT REQUIRED FOR DAY CARE) BMI > 85% age/sex. Yes No And any two of the following ...
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State of il sports physical form