2019-2020 Season Sports Physicals for High School and Middle School Boys & Girls
Date: August 7, 2019
Time: 4:00 PM to 6:00 PM
Location: Medical Office Building Lobby • 700 E. Center Street, Douglas, WY
Cost: $20.00
**All Paperwork Must Be Completed Prior to Arrival**
Participation on this day ensures full participation on the first day of practice this coming Fall. All athletes must have 9 practices in before the first game of the season.
The Sports Physical Clinic is for Healthy Student Athletes Only. Student athletes with any of the health conditions listed below require a more comprehensive physical and will not be allowed to participate in the Sports Physical Clinic. These student athletes should schedule an appointment with their Primary Care Provider to be evaluated for sports participation clearance.
All paperwork must be completed and signed by the student and parent/guardian prior to the Sports Physical Clinic on August 7, 2019.
Links to Memorial Hospital paperwork for printing:
Paperwork may also be picked up at the school, rec center or Medical Office Building.
NOTE: The school district has separate paperwork that must also be filled out before participation in school sports.
Sports Physicals Clinic Health Condition Exclusions:
- Previous denial or restrictions to sports by your provider
- Ongoing medical conditions:
- ASTHMA IN ANY FORM/USE OF INHALERS
- Diabetes
- Ever having a seizure
- Headaches w/exercise
- Numbness, tingling or weakness in arms or legs
- Heat stroke while exercising or past history of heat stroke
- Ever having passed out during or after exercise
- Discomfort, pain, pressure, heart racing or skipping beats during exercise
- Ever having a test for your heart (ECG, Echocardiogram, etc) that has had abnormal results
- Previous x-rays for neck instability
- Regular use of orthopedic brace or frequent pain or weakness in bones or joints (if you are cleared by an orthopedic doctor, then you can participate)
- Coughing, wheezing, or difficulty breathing during and after exercise
- Mono in the past month
- Head injury or concussion in past year, without previous clearance by a provider.
Thank you for your complete and honest attention to this matter.