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May 2024
TO: PARENTS OF MHSA SPORTS PARTICIPANTS
LICENSED MEDICAL PROFESSIONALS
FROM: BRIAN MICHELOTTI, EXECUTIVE DIRECTOR
RE: UPDATED MHSA PRE-PARTICIPATION PHYSICAL EXAM FORM
Article II, Section (3) of the MHSA Handbook requires that a physical exam must be completed for a student to be considered eligible for participation in an Association contest. Physical exams must be completed prior to the first practice. This examination must be certified by a licensed medical professional acting within the scope and limitations of his/her practice. This certification is valid for a period of one school year. A physical examination conducted before May 1st is not valid for participation for the following school year.
Logan Health, the official health care provider of the MHSA, is a sponsor of the MHSA Pre-Participation Physical Form. Parents/guardians may use the medial provider of their choice for the Pre-Participation Physical Examination for their student athlete.
The MHSA Executive Board recently approved important additions to this form. Specifically, PHQ-4 questions concerning mental health of the student were added and the format of the document was updated.
This MHSA pre-participation form is the only form that will be allowed for the student’s exam (no other forms will be accepted). The following process should be followed:
Parent(s)/legal guardian(s) and their student will fill out the History portion of the form together.
The student and parent/guardian will sign the form.
A medical provider will review the form with the student and parent/guardian and perform the exam. A signature from the medical provider is required to clear the student for participation.
The completed MHSA Pre-participation Physical Exam form will be given to the appropriate school administrator.
The MHSA is committed to the safety and health of our student activity participants and believes this new form will facilitate that objective.
If you have any questions regarding the updated pre-participation examination form, please contact me or the MHSA sports medicine liaison, Greta Buehler.