Medical InformationPIAA Forms
- Please note-there has been no revisions to the PIAA forms for the Fall (2020) Season. The bottom of the first page should state Revised: March 22, 2017. There were some changes to the additional CHS sports paperwork that is included in the 2020 Complete Fall Sports Package below (The Risk and Guideline Form along with the Rothman Impact Consent Forms).
Students who intend to participate during the Fall (2020) Season are required to Complete the Following 3 Forms. All forms must be dated after 6/1/20:
All 3 Forms must be completed and submitted to the Athletic Office for review/approval in order for a student to be eligible to participate. The 2020 Complete Fall Sports Package is available here.
- 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).
*All Athletes must submit the Conestoga High School Parent/Guardian Assumption of Risk and Acknowledgement of Guidelines Signature Form. This form must be signed in accordance with the Rules and Guidelines, School Board Policy and the Concussion and Cardiac Arrest information available below.**All students must complete the Impact Consent Form; however, students are tested on a two-year cycle. If a student was tested during the 2019-2020 school year, they do not need a new Impact Baseline Test.
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, 2019.
- 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 medical questions, please contact the Athletic Trainers: Jess McCloskey or Sarah Chaya.