2012-2013 PIAA Physical Form
PIAA Student Athlete Form 2012-2013
(revised July 26, 2012 - updated April 16, 2013)
Due to the enacting of new legislation on Sudden Cardiac Arrest by the Pennsylvania Legislature, the PIAA Physical Form was revised on July 26, 2012. In addition to Section 3: Concussion and Traumatic Brain Injury, which was added earlier this year; the physical evaluation form now includes Section 4: Understanding of Sudden Cardiac Arrest Symptoms and Warning Signs.
All high school students participating in (or desiring to participate in) and their parent/guardians, must review, sign and return an acknowledgement of receipt and review of an Athlete/Parent/Guardian Sudden Cardiac Arrest Symptoms and Warning Signs Information Sheet and Acknowledgement of Receipt and Review Form.
Those needing a physical can go to Coordinated Health's Care on Demand facility (CHCD). The cost of a physical is $25. CHCD is located at 2300-2310 Highland Avenue, Bethlehem, PA 18020.
Those students who have completed and turned in physical forms prior to this addition only need to download and complete the new section and return it to the school trainer or the Main Office. When doing so please note that this is an addition to your paperwork.
Athletic activity includes PIAA interscholastic athletics offered at BECA. Please note that a student athlete cannot begin fall practice on Monday, August 13th without this signed form turned in to the school trainer or to the Main Office.
Additional information on Sudden Cardiac Arrest can be found on the Pennsylvania State Department of Health's web site.
If you have any questions, please do not hesitate to contact Mr. Matt Wiswesser, School Trainer, at firstname.lastname@example.org or 610-866-0791 ext. 27.
Last Modified on April 17, 2013