AHSAA Rule 1, Section 14 makes a student in grades 7 to 12 ineligible for interscholastic athletics until a current physician's statement that the student passed a physical exam is on file in the superintendent's or principal's office. Form 5, the revised 2018 Preparticipation Physical Evaluation, is that statement, with the history on page 1 and the exam and clearance on page 2.
The student and parent complete and sign the page 1 history. The examining physician completes the page 2 physical examination and clearance and signs as M.D. or D.O.
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Preparticipation Physical Evaluation Form (AHSAA Physician's Certificate)
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No. Rule 1, Section 14 requires the examining physician's statement, and the form says it must be signed and dated by the attending physician, M.D. or D.O., even if the physical was completed by a CRNP or PA. The physician circles M.D. or D.O. next to the signature.
AHSAA counts a physical for one calendar year through the end of the month in which it was given. The form's example: a physical on May 5, 2026 satisfies the requirement through May 31, 2027. A new Form 5 is needed after that.
Page 1 covers prior restrictions, hospital stays and surgery, medications and allergies, exercise-related fainting or chest pain, family heart disease or sudden death before 50, prior heart tests, concussion, heat illness, sickle cell trait in the athlete or family, injuries and menstrual history.