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Athletic Physical Clinic 2017

PRE PARTICIPATION PHYSICAL EVALUATION FORM

USD #365 Athletic & Health Services
together with the Family Care Center Present….

Athletic Physical Clinic 2017


What:      Athletic Physicals for the 2017-2018 school year

*Allow 45-60 minutes to complete the physical evaluation*

Where:    ACJSHS Gymnasium Check-in: West interior gym doors

When:     Wednesday, May 17th, 2017   5:15-7:30pm 

Who:      Any USD 365 or St. Rose student grades 6-12 participating in cheer, dance or any other athletic activity MUST have a yearly physical on file at school BEFORE any participation

Providers: Dr. Belcher, Dr. Peterson, Dr. Kimball, Dr.  Jones                                                        Shana Pedrow, NP, Sara Nuessen, PA, Christy Winter, PA, Crystal Neises, NP


***only KSHSAA forms will be completed***

Appointments slots are limited
Call Rochelle, Holly, Linda or Becca at the high school 448-3115 to make an appointment

Physical forms are available in each school office or click here to download

2017-2018 Medical/Insurance Permit Form click here to download

2017-2018 KSHSAA Concussion Form click here to download


The USD 365 Sports Physical Clinic is an optional service. The athletic physical obtained is not intended to be a complete and thorough physical exam but is intended to assist in identifying students at high risk for injury.