ATHLETIC HEALTH HISTORY FORMS MAY NOT BE SUBMITTED UNTIL ONE MONTH PRIOR TO
THE START OF EACH NEW SEASON. ONLY ONE SPORT MAY BE CHECKED.
IF YOUR CHILD'S PRIVATE PHYSICIAN IS GOING TO PERFORM THE SPORT PHYSICAL, SEE
THE PROTOCOL BELOW, AND IT MUST BE SUBMITTED TO THE SCHOOL NURSE ONE MONTH
PRIOR TO THE START OF THE SEASON TO AVOID ANY DELAY IN PARTICIPATION
**NEW PROTOCOL FOR SPORT PHYSICALS** IF YOU CHOOSE TO HAVE YOUR CHILD'S
PRIVATE PHYSICIAN PERFORM THE C.C.S.D. SPORT PHYSICAL, PLEASE NOTE THE PROPER
PROCEDURE
Private Medical Doctor Sport Physical Procedure
• Physicals must be done on the C.C.S.D. B.O.E. approved sport
physical
form. Attachments will not be accepted.
• Physicals must be dated & stamped with examining physicians stamp.
• EVERY LINE MUST BE COMPLETED. Any incomplete examinations will be
sent home to be completed by examining physician, & must be STAMPED & DATED
AGAIN with PMD stamp.
• Per Section One regulation, all athletic physicals must be signed off
on by the school’s B.O.E. approved Medical Examiner, Dr. H. Rojas. If Dr.
Rojas requires further clearance for a particular athlete, that athlete,
parent or guardian will be notified of such, and the athlete will not be
cleared for participation until clearance has been received and reviewed.
PLEASE NOTE, IT MAY TAKE UP TO A WEEK FOR A PRIVATE PHYSICIAN PHYSICAL TO BE
RETURNED FROM DR. ROJAS' OFFICE. KEEP THIS IN MIND WHEN TRYOUTS FOR SPORTS
ARE IMMINENT
Only after all of the above has been done, will a verification card be issued
by the athlete’s school nurse.
Thank you in advance for your cooperation & understanding.