Is your son or daughter interested in
playing sports at Providence High School?
ImPACT Baseline Concussion Exams
Additionally, students interested in participating in athletics at PHS will also need to take an ImPACT baseline concussion exam before they can be cleared for tryouts, practices, workouts or games/events. Once I have all of your child's clearance documentation I can schedule this appointment for them to go with a group to the PSJMC concussion clinic next door.
These appointments are scheduled in groups only and are set for immediately after school (3:00pm or 3:15pm and last for about 30-45 minutes). Due to the fact that PSJMC Concussion Clinic performs our baseline tests for free, we are unable to schedule individual appointment times. ImPACT permission forms are located under the FORMS tab once you get your Sportsware Login
Pre Participation Physical Form (Required)
See our attached required physical form in fillable PDF format at the bottom of this page for your convenience.
A.) The first page of this form (HISTORY) should be completed by a parent or guardian either in fillable PDF format or blue or black ink only (no pencil please).Please make note of the grade that your child will be going into in the Fall of 2018 (not their current grade) Please make sure to read the instructions on the form carefully and that you and your child sign and date where appropriate.
Please make sure that for every "YES" answer checked that you give an explanation including month and year as well as the related explanation including side of the body (left or right) as well as body part on the lines at the bottom right-hand corner of the page (ie; if you checked "YES" for question #9 you should write or type: "#9 "March/2015 fractured left arm"
Please remember to either type these responses or make sure they are legible. If you need more space you can use the back of the form or another sheet of paper attached
Please contact our Athletic Trainer, Sonnie DaCosta, if you have any questions or concerns.