The FHSAA EL2 Form, known officially as the Florida High School Athletic Association Preparticipation Physical Evaluation, is a critical document that ensures the health and safety of high school athletes in Florida. It requires a comprehensive health examination and medical history review, and remains valid for 365 calendar days from the evaluation date noted on the form. This document, non-transferable and school-specific, plays a pivotal role in safeguarding student-athletes' well-being, thereby facilitating their participation in sports. For those looking to fill out the form, consider clicking the button below to ensure all requirements are met.
Navigating the requirements for high school athletics participation can be a complex process, but understanding the essential documents is a great place to start. Among these, the Florida High School Athletic Association Preparticipation Physical Evaluation, commonly referred to as the FHSAA EL2 form, stands out as pivotal. Revised in March 2016, this three-page document is crucial for ensuring the safety and readiness of students to engage in sports. It must be completed and maintained on file by the school for a duration of 365 calendar days from the assessment date indicated on the second page. The form encompasses comprehensive sections including student information, a detailed medical history to be filled out by the student or parent, and a physical examination to be conducted by a licensed medical professional. The EL2 form meticulously screens for any medical conditions or history that could influence a student's ability to safely participate in sports activities. It’s noteworthy that this form is not transferable—if a student changes schools during its validity, the initial page must be re-submitted at the new school. This ensures that the participating institutions have the most relevant and up-to-date health information on their athletes. With sections ranging from emergency contact information, medical history queries, to a thorough assessment by a medical professional, the EL2 form is integral in facilitating student athletes' health and safety on the field.
EL2
Florida High School Athletic Association
Preparticipation Physical Evaluation (Page 1 of 3)
REVISED 03/16
This completed form must be kept on ile by the school. This form is valid for 365 calendar days from the date of the evaluation as written on page 2.
This form is non-transferable; a change of schools during the validity period of this form will require page 1 of this form to be re-submitted.
Part 1. Student Information (to be completed by student or parent)
Student’s Name: ________________________________________________________________________ Sex: _____ Age: _____ Date of Birth: _____/ _____/ _____
School: ____________________________________________________ Grade in School: _____ Sport(s): ________________________________________________
Home Address: _______________________________________________________________________________________ Home Phone: ( _____) _______________
Name of Parent/Guardian: _______________________________________________________________ E-mail: ___________________________________________
Person to Contact in Case of Emergency: _____________________________________________________________________________________________________
Relationship to Student: _______________________ Home Phone: ( _____) ______________ Work Phone: ( _____) _____________ Cell Phone: ( _____) _____________
Personal/Family Physician: ___________________________________________City/State: ___________________________ Ofice Phone: ( _____) _____________
Part 2. Medical History (to be completed by student or parent). Explain “yes” answers below. Circle questions you don’t know answers to.
Yes
No
1.
Have you had a medical illness or injury since your last
____
check up or sports physical?
2.
Do you have an ongoing chronic illness?
3.
Have you ever been hospitalized overnight?
4.
Have you ever had surgery?
5.
Are you currently taking any prescription or non-
prescription (over-the-counter) medications or pills or
using an inhaler?
6.
Have you ever taken any supplements or vitamins to
help you gain or lose weight or improve your
performance?
7.
Do you have any allergies (for example, pollen, latex,
medicine, food or stinging insects)?
8.
Have you ever had a rash or hives develop during or
after exercise?
9.
Have you ever passed out during or after exercise?
10.
Have you ever been dizzy during or after exercise?
11.
Have you ever had chest pain during or after exercise?
12.
Do you get tired more quickly than your friends do
during exercise?
13.
Have you ever had racing of your heart or skipped
heartbeats?
14.
Have you had high blood pressure or high cholesterol?
15.
Have you ever been told you have a heart murmur?
16.
Has any family member or relative died of heart
problems or sudden death before age 50?
17.
Have you had a severe viral infection (for example,
myocarditis or mononucleosis) within the last month?
18.
Has a physician ever denied or restricted your
participation in sports for any heart problems?
19.
Do you have any current skin problems (for example,
itching, rashes, acne, warts, fungus, blisters or pressure sores)?
20.
Have you ever had a head injury or concussion?
21.
Have you ever been knocked out, become unconscious
or lost your memory?
22.
Have you ever had a seizure?
23.
Do you have frequent or severe headaches?
24.
Have you ever had numbness or tingling in your arms,
hands, legs or feet?
25. Have you ever had a stinger, burner or pinched nerve?
26.
Have you ever become ill from exercising in the heat?
27.
Do you cough, wheeze or have trouble breathing during or after
activity?
28.
Do you have asthma?
29.
Do you have seasonal allergies that require medical treatment?
30.
Do you use any special protective or corrective equipment or
medical devices that aren’t usually used for your sport or position
(for example, knee brace, special neck roll, foot orthotics, shunt,
retainer on your teeth or hearing aid)?
31.
Have you had any problems with your eyes or vision?
32.
Do you wear glasses, contacts or protective eyewear?
33.
Have you ever had a sprain, strain or swelling after injury?
34.
Have you broken or fractured any bones or dislocated any joints?
35.
Have you had any other problems with pain or swelling in muscles,
tendons, bones or joints?
If yes, check appropriate blank and explain below:
___ Head
___ Elbow
___ Hip
___ Neck
___ Forearm
___ Thigh
___ Back
___ Wrist
___ Knee
___ Chest
___ Hand
___ Shin/Calf
___ Shoulder
___ Finger
___ Ankle
___ Upper Arm
___ Foot
36.
Do you want to weigh more or less than you do now?
37.
Do you lose weight regularly to meet weight requirements for your
sport?
38.
Do you feel stressed out?
39.
Have you ever been diagnosed with sickle cell anemia?
40.
Have you ever been diagnosed with having the sickle cell trait?
41.
Record the dates of your most recent immunizations (shots) for:
Tetanus: _______________
Measles: _______________
Hepatitus B: ____________
Chickenpox: ____________
FEMALES ONLY (optional)
42.When was your irst menstrual period? _______________________
43.When was your most recent menstrual period? _________________
44.How much time do you usually have from the start of one period to the start of another?_______________________________________
45.How many periods have you had in the last year? _______________
46.What was the longest time between periods in the last year? ________
Explain “Yes” answers here:_______________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
We hereby state, to the best of our knowledge, that our answers to the above questions are complete and correct. In addition to the routine medical evaluation required by s.1006.20, Florida Statutes, and FHSAA Bylaw 9.7, we understand and acknowledge that we are hereby advised that the student should undergo a cardiovascular assessment, which may include such diagnostic tests as electrocardiogram (EKG), echocardiogram (ECG) and/or cardio stress test.
Signature of Student: _____________________________________ Date: ____/ ____/ ____ Signature of Parent/Guardian: __________________________________ Date: ____/ ____/ ____
– 1 –
Preparticipation Physical Evaluation (Page 2 of 3)
Part 3. Physical Examination (to be completed by licensed physician, licensed osteopathic physician, licensed chiropractic physi- cian, licensed physician assistant or certiied advanced registered nurse practitioner).
Student’s Name: _____________________________________________________________________________________________ Date of Birth: _____/_____/_____
Height: _____________ Weight: _____________ % Body Fat (optional): ____________ Pulse: _________ Blood Pressure: ____ / ____ ( ____/____ , ____ /____ )
Temperature: _____________ Hearing: right: P ______ F _____ left: P _____ F _____
Visual Acuity: Right 20/_______
Left 20/_______
Corrected: Yes
Pupils: Equal _________ Unequal _________
FINDINGS
NORMAL
ABNORMAL FINDINGS
INITIALS*
MEDICAL
Appearance
________
________________________________________________________________________
____________
Eyes/Ears/Nose/Throat
Lymph Nodes
Heart
Pulses
Lungs
Abdomen
Genitalia (males only)
Skin
MUSCULOSKELETAL
Neck
Back
Shoulder/Arm
Elbow/Forearm
Wrist/Hand
Hip/Thigh
Knee
Leg/Ankle
Foot
* – station-based examination only
ASSESSMENT OF EXAMINING PHYSICIAN/PHYSICIAN ASSISTANT/NURSE PRACTITIONER
I hereby certify that each examination listed above was performed by myself or an individual under my direct supervision with the following conclusion(s):
____ Cleared without limitation
____ Disability: _____________________________________________________ Diagnosis: ___________________________________________________________
_______________________________________________________________________________________________________________________________________
____ Precautions: ________________________________________________________________________________________________________________________
____ Not cleared for: __________________________________________________________________________ Reason: ___________________________________
____ Cleared after completing evaluation/rehabilitation for: ______________________________________________________________________________________
____ Referred to ______________________________________________________________________________ For: ______________________________________
Recommendations: _______________________________________________________________________________________________________________________
Name of Physician/Physician Assistant/Nurse Practitioner (print): __________________________________________________________ Date: _____/_____/_______
Address: _______________________________________________________________________________________________________________________________
Signature of Physician/Physician Assistant/Nurse Practitioner: ____________________________________________________________________________________
– 2 –
Preparticipation Physical Evaluation (Page 3 of 3)
Student’s Name: _____________________________________________________________________________________________
ASSESSMENT OF PHYSICIAN TO WHOM REFERRED (if applicable)
I hereby certify that the examination(s) for which referred was/were performed by myself or an individual under my direct supervision with the following conclusion(s):
Name of Physician (print): ___________________________________________________________________________________________ Date: ____/____/_______
Signature of Physician: ___________________________________________________________________________________________________________________
Based on recommendations developed by the American Academy of Family Physicians, American Academy of Pediatrics, American Medical Society for Sports Medicine, American Orthopae- dic Society for Sports Medicine and American Osteopathic Academy for Sports Medicine.
– 3 –
In the realm of school athletics, ensuring the physical well-being of student-athletes is paramount. Prior to participation, a Preparticipation Physical Evaluation, known as the FHSAA EL2 form, must be diligently completed. This form, crucial for the health and safety of young athletes, serves as a detailed record of their medical history and physical fitness. Its completion is a step toward safeguarding participants from potential health risks associated with competitive sports. The following steps provide a guide through the form's three-page span, ensuring both accuracy and compliance.
Once all sections of the FHSAA EL2 form are meticulously completed, reviewed for accuracy, and properly signed, the form must be submitted to the appropriate school authorities to fulfill the requirements set forth for athletic participation. The form remains valid for 365 calendar days from the date of the medical evaluation. This time-sensitive validity underscores the need for annual re-evaluation, ensuring ongoing fitness and safety of the student in their athletic endeavors.
What is the FHSAA EL2 Form?
The FHSAA EL2 form is a Preparticipation Physical Evaluation form that must be completed for students wishing to participate in high school sports in Florida. It serves as a comprehensive assessment of a student's physical ability to engage in athletic activities, helping ensure their safety and well-being on the field or court. This form comes in three parts, including student information, medical history, and a physical examination section to be filled out by a licensed medical professional. It remains valid for 365 calendar days from the evaluation date.
Who needs to complete the EL2 Form?
Any high school student in Florida interested in joining a sports team under the Florida High School Athletic Association (FHSAA) is required to complete the EL2 form. It is a prerequisite for participation in sports, aiming to identify any potential risks to the student's health during athletic activities.
What is the validity period of the EL2 Form?
The EL2 Form is valid for 365 calendar days from the date of the medical evaluation as indicated on page 2 of the form. This timeframe ensures that the medical assessment reflects the student's current health status, considering that a student's physical condition can change.
Is the EL2 Form transferable between schools?
No, the EL2 Form is not transferable between schools. If a student changes schools during the validity period of the form, page 1 of the EL2 Form must be resubmitted at the new school. This policy helps maintain accurate and current medical records for student-athletes across different institutions.
What happens if the form expires during the sports season?
If the EL2 Form expires during the sports season, the student must undergo another physical evaluation and submit a new form to continue their participation. This ensures ongoing monitoring of the student's health and fitness for sports activities.
Can a chiropractic physician complete the physical examination section of the EL2 Form?
Yes, a licensed chiropractic physician is one of the medical professionals authorized to complete the physical examination section of the EL2 Form. Additionally, licensed physicians, osteopathic physicians, physician assistants, and certified advanced registered nurse practitioners can also conduct the examination.
What information is required in the medical history section of the EL2 Form?
The medical history section of the EL2 Form requires detailed information about the student's past and present health status. It includes questions regarding medical illnesses or injuries since the last check-up, chronic illnesses, hospitalizations, surgeries, medication use, allergies, and more. This comprehensive medical history helps identify any health concerns that might affect the student's ability to safely participate in sports.
Who is responsible for ensuring the EL2 Form is updated and submitted?
It is typically the responsibility of the student and their parent or guardian to ensure the EL2 Form is accurately filled out, updated as necessary, and submitted to the appropriate school authorities. This collaborative effort helps streamline the process of maintaining up-to-date health records for student-athletes, facilitating a safe sports environment.
Filling out the FHSAA EL2 form, crucial for student-athletes in Florida, can sometimes be a complicated and error-prone task. A common mistake is not providing complete student information in Part 1. This section, which requires detailed data including the student's name, age, date of birth, school, home address, and sports participation details, is often rushed through. Leaving out any piece of this information can lead to unnecessary delays or even the invalidation of the form, potentially sidelining the student from participating in their sport.
Another frequent oversight involves the Medical History section in Part 2, where students or their parents must answer a comprehensive list of health-related questions. Sometimes, the explanations for "yes" responses are insufficient or entirely skipped. Providing detailed explanations is crucial for a thorough evaluation of the student's health status and to determine their eligibility or need for further medical assessment. This incomplete information may cause healthcare providers to miss or misunderstand key aspects of the student's medical history.
Accuracy in completing the medical history questions is also indispensable. It is too often that the circle questions indicating uncertainty ("Circle questions you don’t know the answers to") are left untouched. This failure to acknowledge uncertainties may lead healthcare providers to assume a more thorough understanding of the student's medical history than actually exists, potentially overlooking risks that could affect the student's health during participation in athletic activities.
The section requiring signatures at the end of Part 2 is also a critical yet commonly mishandled step. Occasionally, signatures of both the student and the parent or guardian are missing or not dated correctly. These signatures are a mandatory part of the form, serving as verification that the information provided is accurate and complete to the best of the signees' knowledge. Without these signatures, the form is considered incomplete, which can delay or impede the student's eligibility for participation.
Last but not least, an error that can occur lies within the Physical Examination section in Part 3. This part must be completed by a licensed professional, and yet, at times, it is either partially filled or inaccuracies are found in reporting the medical findings. Each examination listed must be conducted or directly supervised by the signing healthcare provider. Any deviation from this can bring into question the validity of the examination results, impacting the student's clearance for participation in sports activities. Keeping these common pitfalls in mind and approaching the form with thorough attention can ensure a smoother, unimpeded process for student-athletes seeking clearance for participation.
When a student-athlete prepares to participate in school sports, several important documents usually accompany the Florida High School Athletic Association (FHSAA) EL2 form, known as the Preparticipation Physical Evaluation. These forms work together to ensure the safety and readiness of the athlete for the physical demands of their chosen sports. Understanding these forms can provide parents, guardians, and students with clarity on what is required for sports participation.
Each of these forms plays a specific role in ensuring student-athletes are eligible, safe, and properly informed about their participation in sports activities. Completing and understanding these documents will help streamline the process of participating in high school athletics, ensuring a positive and safe sports experience for all involved. Sports administration at member schools can provide guidance on how and when to submit these documents, ensuring adherence to FHSAA policies and regulations.
The NCAA Sports Medicine Handbook Preparticipation Physical Evaluation mirrors the FHSAA EL2 form in several ways. Primarily utilized for college athletes, it is designed to identify health conditions that may warrant further investigation before allowing participation in sports. Similar to the EL2 form, it includes sections for personal and family medical histories, a thorough physical examination, and a conclusion by examining medical professionals about the athlete's clearance status. This process ensures that athletes are in optimal health and that any potential risks associated with sports participation are assessed and managed appropriately.
The Pre-Employment Physical Examination forms used by various employers share common objectives with the FHSAA EL2 form, albeit in a different context. These forms are employed to ensure that potential hires are medically and physically capable of performing specified job tasks. Like the EL2, they may include a detailed medical history, a physical examination by a healthcare professional, and a final determination of the candidate's fitness for work. The overarching goal is to promote safety and prevent workplace injuries, paralleling the EL2's aim to minimize sports-related health risks.
The Boy Scouts of America (BSA) Annual Health and Medical Record is another document similar to the FHSAA EL2 form in purpose and structure. It is required for participants in scouting events to ensure they are physically capable of the demands of scouting activities, which often include outdoor adventures and physical exertion. The form encompasses a health history, a physical exam, and clearance information, much like the EL2 form, focusing on safety and the prevention of injuries during participation in physically demanding activities.
International travel clinics use a Health Screening Form for travelers, which also resembles the FHSAA EL2 form. These forms are meant to assess an individual's health status before traveling abroad, identifying any conditions that might affect their capability to travel or require special medical attention while overseas. Like the EL2, they often include medical history reviews, vaccination records, and a physical assessment to ensure the traveler’s health status is compatible with their travel plans, aiming to prevent health issues while abroad.
The Department of Transportation (DOT) Physical Examination forms are designed to certify the health and fitness of commercial vehicle drivers, ensuring they can safely operate heavy vehicles. This form is akin to the EL2 in that it requires a detailed medical history, a comprehensive physical examination, and results in a certification of fitness if the individual meets specific health standards. Both forms aim to protect the well-being of the individual and those around them by ensuring they are physically capable of performing their duties without undue risk.
When filling out the FHSAA EL2 form, it's important to follow certain dos and don'ts to ensure the information provided is accurate and the form is correctly processed. Here are some guidelines to consider:
Understanding the Florida High School Athletic Association (FHSAA) EL2 form is crucial for student-athletes, parents, and educators. However, there are many misconceptions about this document. Here, we aim to clear up some of the most common misunderstandings:
The EL2 form is transferable between schools. This is a misconception. If a student changes schools, page 1 of the EL2 form must be re-submitted to the new school, as the form is non-transferable.
The physical evaluation is valid indefinitely. In reality, the completed form is only valid for 365 calendar days from the date of the evaluation as noted on page 2.
Any healthcare provider can complete the form. Only specific licensed professionals, including physicians, osteopathic physicians, chiropractic physicians, physician assistants, or certified advanced registered nurse practitioners, are authorized to conduct the physical examination and complete the form.
Student or parent can complete the entire form. While it's true that Part 1 and Part 2 (Student Information and Medical History) are to be completed by the student or parent, Part 3 (Physical Examination) must be completed by a licensed healthcare provider.
Only the current year's physical activity level is considered. The form actually requires disclosure of any serious illnesses or injuries since the last check-up or sports physical, not just occurrences within the current year.
Page 3 is optional and only for referrals. This misunderstanding could result in incomplete submissions. Page 3 contains important information should the student be referred to another physician for further evaluation. If applicable, it needs to be completed and submitted along with the rest of the form.
The form only covers physical health. While physical health is a significant component, the form also inquires about mental health, including questions about stress and feeling stressed out, making it a comprehensive health evaluation.
The form does not need to be updated if there are no health changes. Despite the health status of the student, an updated form must be submitted each year, as it is only valid for 365 days from the physical evaluation date.
All sections of the medical history must be filled out completely. While thoroughness is encouraged, the form actually allows for circling questions if the answers are unknown, ensuring that lack of specific historical details does not preclude participation.
Digital submissions of the form are acceptable. The policy regarding digital submission varies by school. It is essential to check with the specific school's athletic department for their submission policies. However, the form generally needs to be kept on file by the school, implying a requirement for a hard copy.
Addressing these misconceptions ensures that the process of submitting the FHSAA EL2 form is as smooth as possible for students wishing to participate in athletics. Always refer to the latest version of the form and follow the submission guidelines provided by the school's athletic department.
When dealing with the FHSAA EL2 Preparticipation Physical Evaluation form, several key points must be understood to ensure compliance and proper submission:
Understanding these elements can simplify the process of completing the FHSAA EL2 form and ensure students are properly evaluated and cleared for athletic participation.
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