PRE PARTICIPATION PHYSICAL EVALUATION FORM USD #365 Athletic & Health Services |
What: Athletic Physicals for the 2018-2019 school year
*Allow 45-60 minutes to complete the physical evaluation*
Where: ACJSHS Gymnasium Check-in: West interior gym doors
When: Wednesday, May 16th, 2018 5:15-7:30pm
Who: Any USD 365 or St. Rose student grades 6-12 participating in cheer, dance or any other athletic activity MUST have a yearly physical on file at school BEFORE any participation
Providers: Dr. Belcher, Dr. Peterson, Dr. Kimball, Dr. Jones Shana Pedrow, NP, Sara Nuessen, PA, Christy Winter, PA, Crystal Neises, NP
***only KSHSAA forms will be completed***
Appointments slots are limited
Call Holly, Linda or Becca at the high school 448-3115 to make an appointment
Physical forms are available in each school office or click here to download
2018-2019 Medical/Insurance Permit Form click here to download
2018-2019 KSHSAA Concussion Form click here to download
The USD 365 Sports Physical Clinic is an optional service. The athletic physical obtained is not intended to be a complete and thorough physical exam but is intended to assist in identifying students at high risk for injury.