Providence High School

Athletics » Athletics Physical Clearance Documentation

Athletics Physical Clearance Documentation

 

Is your son or daughter interested in

playing sports at Providence High School?

 

Per C.I.F. regulations, PRIOR to athletic participation in tryouts, practices, or games of any sport, an individual must have an Annual Pre Participation Physical Exam (PPE) on file at his/her school. In conjunction with this requirement, Providence High School Policy states that all student-athletes must submit their completed physical prior to participation in any school-sponsored summer camp or summer athletic competition.

 

Clearance Documentation Submission Process
This year, in order to expedite the athletics clearance process we are implementing a new online clearance software via SportsWare. All athletics clearance documents EXCEPT your child's Pre Participation Physical will be available in fillable PDF through SportsWare and must be completed prior to participation in athletics here at PHS.
 
For access to SportsWare please download the PDF document "Sportsware Online Login Instructions" at the bottom of this page and follow the instructions for STEP 1.

 

Please Note: Once your request is accepted you will receive an e-mail with the Subject “SportsWare request accepted”. This email will include instructions for your next steps to get logged in. At this time you will be able to follow the instructions for STEPS 2-6
 

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


In the meantime, you can make an appointment with your child's regular physician to get an athletic pre-participation physical exam, visit the Burbank CVS Minute Clinic (They charge $59 and take walk-ins), or you may sign up for one of our FREE physical days through Exer Urgent Care (May 12th and June 9th. See PDF "2018-2019 Exer Flyer" listed at the bottom of this page) or make your appointment by following the instructions below:

1.) visit http://www.exerurgentcare.com/exer-sports-schools/
2.) Scroll to the bottom of the page to the box with the orange header titled "2018 Sports Physical Day School Lookup" and click on the link for "Providence High School 5/12/18 & 6/9/18"
3.) Click "Sign up" next to the desired location, date and time then click "Submit and Sign Up" at the bottom of the page.
4.) Select your desired appointment time and enter the required information (Childs First Name, Last Name, and YOUR email) then click "Sign Up Now"

Please note: It is highly recommended that you accompany your child to their appointment. If you are unable to attend with them please download and sign the "Free Physical Exam Letter Parent not Present 2018_2019" PDF and have your child bring it with them to their appointment along with a copy of the Physical Form (see directions below) If you need to cancel or change an appointment please contact the Exer location you made your appointment at (either Northridge or Sherman Oaks)

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


B.) The last two pages must be completed by a medical doctor (MD or DO only) or a FNP (Nurse practitioner). Per our school policy, immediate family members (mom, dad, aunt, uncle or grandparents) may not perform students physicals. Forms must also have physicians signature, date, and stamp.

Once your child has completed their physical exam please submit the forms in a sealed envelope with your child's name to Mrs. Sossy Tavidian in the front office. Please do not email or fax forms.

Please contact our Athletic Trainer, Sonnie DaCosta, if you have any questions or concerns.

 

Sonnie DaCosta MS ATC USAW
Athletic Trainer
Providence High School
(818) 846-8141 ext. 14605