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Preparticipation Physical Evaluation Forms: Not All Created Equal

Lack of uniformity poses challenges for parents, programs

Basics

A school or independent youth sports organization (YSO) should require a preparticipation physical exam or evaluation (PPE) before allowing a child to practice or play an organized sport. In most places, not just any PPE form will do. Most schools or sports programs specify the PPE form that has to be completed.

Doctor taking notes for PPE

After the sports season is over, a school or YSO should save the PPE until the child becomes an adult because children have the right to bring lawsuits as adults for injuries they suffered as children. A school or YSO will fare better in court if they can produce their PPEs. 

Use school's PPE form

Most schools and YSOs have lawyers who require that a specific PPE form be used. In my position as an athletic commissioner, I occasionally encounter parents who have trouble with this requirement, often telling me that they have used other forms to certify that their child is healthy. I always have to let these parents down gently, explaining to them that the reason for requiring a specific form is a legal one: no school or YSO can afford to run the risk of one child being certified under one standard and another child being certified under another standard.

No model PPE form

The problem is that there is no uniformity in the forms being used: the decision is made on a school-by-school, program by program basis. It would be far better if there was one form used by every school and sports program.

There is one PPE form which is now used widely enough to be considered the "model form": the fourth edition of the Preparticipation Physical Evaluation Monograph, produced by a consortium of six medical societies (American Academy of Family Physicans, The American Academy of Pediatrics, The American College of Sports Medicine, The American Medical Society For Sports Medicine, The American Orthopaedic Society for Sports Medicine, and the American Osteopathic Academy of Sports Medicine). If you go on the Internet and search "preparticipation physical examination" you'll find a number of versions of this form. (Here's one).

But wait! Don't rush out and pull a random version of the form off the Internet to give to your child's doctor to complete. Some schools and YSO modify the form in stylistic and substantive ways. Check with your school first to make sure your child's physician uses the precise form it requires.

Make Sure The Student Is Really Cleared

Schools - and parents - need to be vigilant in proofing the PPE form. The form has three clearance boxes. The first box is a checkbox where the doctor can indicate that a child is cleared with no restrictions. The third box is a checkbox where the doctor can indicate that a child is not cleared. These two boxes are self-explanatory. The child either can practice or play or can't.

Schools and parents sometimes have difficulty with the form's middle box, which is a box for conditional clearances or more specifically for children who are "Cleared for all sports without restriction with recommendations for further evaluation or treatment for...." Schools, Districts and YSOs have to make sure that whoever is receiving the forms is vigilant enough to read the recommendations for further evaluation and treatment, and to make sure they're implemented.

Sometimes the recommendations on a conditional clearance may seem easy to comply with. For example, a recommendation that a student only practice or play where they have access to their asthma inhaler is self-explanatory. Other recommendations could be more complex. Large organizations such as school districts may wish to have a designated point person address all conditional clearances so that multiple coaches or other people in the organization don't render inconsistent or inappropriate interpretations of the recommendations on the conditional clearance.

How long is A PPE form valid?

In most places, the completed PPE allows a child to play sports for a period of a year, although the time period is longer in some states (in Connecticut, for instance, a high school physical is good for 13 months). It is therefore important for you to check with your child's school or club so you'll know when your child needs to take another physical exam and can schedule the exam in advance. The last thing you want is to have your child pulled off the team in the middle of the season because her physical expired or because you couldn't get her an appointment with her pediatrician.

Saving PPE forms

Schools and YSOs need to save the PPE forms for a long time. I suggest saving the forms until the youngest child on a team is a legal adult. Then, hold the forms for four or five more years - just to play it safe.

Children don't generally have an independent right to sue. Their parents get to make those choices for them. However, once the child becomes an adult he can void his parents' decision not to sue, and bring lawsuits for things that happened a long time ago.

The new adult receives a period of time to bring his/her suit. After that period of time, the kid can't sue. That time period is called the statute of limitations. It's usually one to three years. A sports sponsor should check with its attorney to find out when children become adults for purposes of bringing a lawsuit in its state and to find out how long the statute of limitations period is. The forms should be saved for that length of time - and probably a year or two extra, just to play it safe.

No excuses

Schools, YSOs and parents will occasionally try to make excuses about doing and maintaining PPEs. I've seen schools lose forms because they had a change in athletic directors. I've seen athletic directors who gave the originals to a coach to take to the game, only to have the coach lose them (a tip: give the coach the copies and file the originals). I've had parents argue that their insurance company only covers so many medical checkups per year, or they don't have any health insurance at all, so they can't do a PPE. At the end of the day, no excuses are acceptable. Our kids' health and our schools' money are on the line.


Donald C. Collins is Commissioner of Athletics for the San Francisco Unified School District CIF San Francisco Section, a longtime member of MomsTEAM's Team of Experts, and a member of MomsTEAM Institute's Board of Directors. 

Published July 25, 2017.

Note: This article is an updated version of one which was originally published on MomsTEAM on May 10, 2008. 

 

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