Illinois Sports Physical Form
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Physical Examination Requirements Entire Section Below To Be Completed By Md/Do/Apn/Pa.
Effortlessly add and highlight text, insert images, checkmarks, and signs, drop new fillable areas, and rearrange or delete pages from your paperwork. Baseball | basketball, boys | basketball, girls | bowling | cheerleading | chess. Fill in the required fields (these are yellowish). Asthma anemia diabetes infections other:
Physical Education Yes No Modified Interscholastic Sports (For.
Physical examination requirements entire section below to be completed by md/do/apn/pa. The athlete does not have apparent clinical contraindications to practice and can participate in the sport(s) as outlined on this form. Web state of illinois certificate of child health examination. Web __________________________________________________________________________________________________ i have examined the student named on this form and completed the preparticipation physical evaluation.
Safety Glasses, Glass Eye, Chest Protector For Arrhythmia, Pacemaker, Prosthetic Device, Dental Bridge, False Teeth, Athletic Support/Cup.
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