Oregon Oregon Department of Education

Rule Rule 581-021-0041
Form and Protocol for Sports Physical Examinations


(1)

The State Board of Education adopts by reference the form entitled "School Sports Pre-Participation Examination” dated May, 2017 that must be used to document the physical examination and sets out the protocol for conducting the physical examination. The form may be used in either a hard copy or electronic format. Medical providers may use their electronic health records systems to produce the electronic form. Medical providers conducting physicals of students who participate in extracurricular activities in grades 7 through 12 must use the form.

(2)

The form must contain the following statement above the medical provider’s signature line:
This form is an exact duplicate of the current form required by the State Board of Education containing the same history questions and physical examination findings. I have also reviewed the "Suggested Exam Protocol”.

(3)

Medical providers conducting physicals on or after April 30, 2011 and prior to May 1, 2017 must use the form dated May 2010.

(4)

Medical providers conducting physicals on or after May 1, 2017 and prior to May 1, 2018 may use either the form dated May 2010 or the form dated May, 2017.

(5)

Medical providers conducting physicals on or after May 1, 2018 must use the form dated May, 2017.
NOTE: The form can be found on the Oregon School Activities Association (OSAA) website: www.osaa.org
Source

Last accessed
Jun. 8, 2021