Provider's academic accommodation recommendations for a student recovering from concussion.
- Completed by
- Licensed health care provider
- Issued by
- North Carolina High School Athletic Association (NCHSAA)
- Format
- Language
- English and Spanish
NCHSAA PPE Physical Exam and Medical Eligibility Form
North Carolina student-athletes need a medical examination every 395 days by a licensed physician, nurse practitioner or physician assistant under State Board policy ATHL-005. NCHSAA's 2026-27 preparticipation evaluation has three parts, and the clinician completes two of them: Part 2, the Physical Examination Form, and Part 3, the Medical Eligibility Form that goes to the school.
Who completes it
The same licensed MD, DO, NP or PA-C who reviews the history completes and signs Parts 2 and 3, including the shared emergency information. The student and parent complete and sign the Part 1 history.
Submitting and payment
- How to submit it
- Only the Part 3 Medical Eligibility Form must be returned to the member school; schools may collect Parts 1 and 2 but are not required to keep them.
- Who pays
- NCHSAA sets no fee for the physical and does not say who pays.
Good to know
- Both Parts 2 and 3 should be signed on the date the physical examination was completed.
- The exam should include a thorough review of the history form, with clarifying questions about any blank areas.
- The Part 1 history is posted in English and Spanish; Parts 2 and 3 are English only, and the page's link to Part 3 is labeled Medical Education Form.
- The cardiac exam footnote suggests considering ECG, echocardiography or cardiology referral for abnormal cardiac history or exam findings.
Get the official form
Download the current version from the source each time; forms change without notice.
NCHSAA Preparticipation Physical Evaluation: Physical Examination Form (Part 2) and Medical Eligibility Form (Part 3)
Fill it with Vero
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
How this list is checked
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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Frequently asked questions
How often do North Carolina athletes need a physical?
NCHSAA's page cites State Board of Education policy ATHL-005: a student must have a medical examination every 395 days by a licensed physician, nurse practitioner or physician assistant. The Medical Eligibility Form documents it for the school.
Which NCHSAA PPE part goes to the school?
The Part 3 Medical Eligibility Form must be returned to the member school to meet eligibility requirements. A school may choose to collect the Part 1 history and the Part 2 exam form, but it is not required to keep them.
Who signs the NCHSAA Medical Eligibility Form?
The same licensed medical professional, MD, DO, NP or PA-C, who reviewed the history and completed the Part 2 exam. That professional also fills in the shared emergency information from the history and exam findings and signs on the exam date.