Physician release documenting diagnosis, treatment and contagious status so a wrestler with a skin lesion may compete.
- Completed by
- Physician
- Issued by
- Wisconsin Interscholastic Athletic Association (WIAA)
- Format
- Language
- English
Wisconsin requires a physical every other year for interscholastic athletics, and the PPE Medical Eligibility Form doubles as the WIAA Athletic Permit Card that must be on file at school before practice. The four-page packet also includes the history and physical exam pages, which stay with the provider and family.
The student and parent complete the history and sign the permit card's permission and HIPAA authorization. The examining MD or DO, PA or APNP completes the exam, marks eligibility and signs the card; physicians may authorize nurse practitioners to stamp the physician's signature or clinic name.
Download the current version from the source each time; forms change without notice.
Student-Athlete Physical Card (Pre-Participation Physical Evaluation, 5th Edition)
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.
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Two school years. An exam taken April 1 or later is valid for the following two school years; an exam taken before April 1 is valid only for the remainder of that school year and the following school year. Parents file an alternate-year card in between.
The signature line reads health care professional (MD or DO), PA or APNP. A footnote lets physicians authorize nurse practitioners to stamp the card with the physician's signature or the name of the clinic the physician is affiliated with.
Yes. WIAA posts a Spanish copy of the PPE form on its health and safety page, and the Alternate-Year Physical Card that parents complete in off years is available in English, Spanish and Hmong.