Conestoga High School Athletics: Medical InformationPIAA Forms
- Please note-there has been no revisions to the forms for the 2018 Fall Season. The bottom of the first page should state Revised: March 22, 2017.
Athletes who intend to participate in a sport for the Fall (2018) Season are required to Complete the Following 3 Forms:
All 3 Forms must be completed and submitted to the Athletic Office for review/approval (preferably in person) in order for a student to be eligible to participate. All Forms must be dated after June 1, 2018. You can download the complete (2018) Fall Sports Package here: (2018)Fall Sports Package
- Sections 1-6 of the PIAA Comprehensive Initial Pre-Participation Evaluation.
- Assumption of Risk, Student Accident, Injury and Guidelines Form
- Impact Consent Form (This form must be completed even if a particular sport does not require an actual impact test and/or if a student is not in their scheduled cycle year to be tested for the Baseline Impact Test.
- Fall Sports Forms will be collected starting on Monday, July 2, 2018 through Friday, August 3, 2018 between the hours of 7:00am and 2:30pm in the Athletic Office.
- Fall Sports begin on Monday, August 13th for V/JV/JVA Teams and Monday, August 27th for JVB/Freshman Teams.
PIAA Comprehensive Initial Pre-Participation Physical Evaluation (CIPPE) has several pages that need to be completed:
- Section 1: Personal and Emergency Information sheet.
- Section 2: Certification of Parent/Guardian signed next to the sport the student intends to play, as well as where indicated in parts “B” through “F”
- Section 3: Understanding of Risk of Concussion and Traumatic Brain Injury
- Section 4: Understanding of Sudden Cardiac Arrest Symptoms and Warning Signs
- Section 5: Health History to be completed by parent/guardian
- Section 6: PIAA Comprehensive Initial Pre-Participation Physical Examination and Certification of Authorized Medical Examiner. This should be completed by the student’s physician no earlier than June 1, 2017.
- Section 7: Parent Re-Certification form. By completing this form, the parent or guardian is assuming responsibility that the student’s health is unchanged since he/she was seen by a physician. This form must be completed if the physical has been performed before.
- Section 8: Physician Re-Certification form. This form is only needed if a child has been under a doctor’s care for an injury or illness since their physical.
**NOTE: The misrepresentation of student health information can lead to harmful consequences. Any misrepresentation of a student’s medical status, by either the student or the parent or the guardian, will result in a season’s suspension from interscholastic sports participation.**
If you have any questions, please contact the Athletic Office at (610) 240-1024.**For clearance/medical release from a skin lesion, the following PIAA/NFHS form must be completed in its entirety, and returned to the athletic trainers. Please contact Jess McCloskey or Sarah Chaya if you have any questions. Skin Lesion Clearance