This one-page exam sheet from the Preparticipation Physical Evaluation monograph, 6th edition, records the clinician's sports physical: vitals, vision, a system-based medical exam and a nine-region musculoskeletal check. Clinicians meet it at school and club sports physicals, often in a state association's adapted version. It stays in the chart, while the separate Medical Eligibility Form carries the clearance decision to the school.
The examining MD, DO, NP or PA completes and signs the whole form. The athlete and parent or guardian fill out the separate PPE History Form before the visit, and the clinician reviews it with them before examining.
Enter the athlete's full name and date of birth at the top of the sheet. The exam form is one of a set: the History Form completed by the athlete and parent, this clinician exam, and the Medical Eligibility Form that goes to the school. The AAP encourages athletes and parents to fill out the History Form together before the visit, so review it before starting the exam.
A prompt box rather than a scored section. It suggests more sensitive questions: feeling stressed or pressured, having enough food at home, worry about homelessness, feeling safe at home, school and in sports, cigarette, e-cigarette or smokeless tobacco use (including in the past 30 days), alcohol or drug use, seat belts, helmets and condoms, and anabolic steroids or supplements for weight or performance. The AAP advises reviewing history privately with the athlete and guardian, and with the athlete alone when needed.
Record height, weight, blood pressure and pulse, then visual acuity for each eye written as R 20/__ and L 20/__, with a Y or N box for whether vision was tested corrected. These vitals sit above the system review, so complete them before marking the medical and musculoskeletal rows.
Mark each row normal or abnormal and describe any abnormal finding. Rows cover appearance, including Marfan stigmata (kyphoscoliosis, high-arched palate, pectus excavatum, arachnodactyly, hyperlaxity, myopia); eyes, ears, nose and throat; lymph nodes; cardiovascular, including murmurs on standing and supine auscultation with or without Valsalva, and radial and femoral pulses; lungs; abdomen, including masses, enlarged liver or spleen and CVA tenderness; skin, including HSV, Staphylococcus aureus and tinea corporis; and neurological.
Mark normal or abnormal and note findings for the neck, back, shoulder and arm, elbow and forearm, wrist, hand and fingers, hip and thigh, knee, leg and ankle, and foot and toes. A final Functional row suggests considering a single-leg squat test and/or box drop test to screen movement quality.
A printed line below the exam grid reminds the clinician to consider electrocardiography, echocardiography or referral to a cardiologist when the cardiac history or examination is abnormal. It is a prompt for targeted follow-up, not a routine step: the AAP states that routine screening tests such as labs and ECG are not recommended for every athlete.
Print or type the health care professional's name, then add the date, address and phone number, and sign on the line ending MD, DO, NP or PA. After signing, record the participation decision on the Medical Eligibility Form, which offers options from eligible without restrictions to not eligible, and file this exam sheet in the chart.
Download the current version from the source each time; forms change without notice.
Preparticipation Evaluation: Physical Examination Form
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Sources for this guide
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The signature line on the 6th-edition form names an MD, DO, NP or PA. The examining clinician prints their name, address and phone, dates the sheet and signs it. The same clinician then records the clearance decision on the separate Medical Eligibility Form, which is the only PPE form meant for the school or league.
No. The form itself says it belongs in the individual's medical file and should be shared only with other health care professionals. The AAP adds that a PPE performed in a clinical setting is protected by HIPAA, so consent is needed before sharing it with nonmedical school staff. Give the school the Medical Eligibility Form instead.
No. The AAP states that routine screening tests such as labs and ECG are not recommended. The exam form suggests considering an ECG, echocardiography or referral to a cardiologist only when the cardiac history or examination is abnormal, for example a murmur heard on standing or supine auscultation or Marfan features.
The AAP posts the PPE History Form, which the athlete and parent complete, in English and Spanish. Its page says the physical examination and eligibility forms also come in both languages, but it links only the English versions of those two, so the exam sheet is used in English in practice.