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Dodea sports physical form

DoDEA Form 21 SHSM H-12-3 Sport Physical 2026

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The document is a Sports Physical Clearance Form used by the Department of Defense Education Activity (DoDEA) to collect health-related information for students enrolling in DoDEA schools. It outlines the process for obtaining a sports physical examination, including sections for student information and physician clearance. The form emphasizes the importance of providing accurate health data to ensure student safety and access to educational services.

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Click ‘Get Form’ to open the DoDEA Form 21 SHSM H-12-3 Sport Physical in the editor.
Begin by filling out the 'Completed by STUDENT' section. Enter the student's name, date of birth, and grade accurately to ensure proper identification.
Next, move to the 'Completed by Examining Physician/PCM' section. Here, the physician will indicate whether the student is cleared for sports participation by checking 'YES' or 'NO'.
The physician must also provide the date of the physical exam and any restrictions or medical conditions that may affect sports participation. Ensure this information is clear and complete.
Finally, have the examining physician print their name and title, followed by their signature and stamp. This validates the form for submission.

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Versions	Form popularity	Fillable & printable
2017	4.9 Satisfied (53 Votes)

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How to complete a sports physical?

Physical Examination record your height and weight. check your blood pressure and pulse (heart rate and rhythm) test your vision. check your heart and lungs. examine your muscles, bones, and joints.

What is the purpose of the DoDEA?

DoDEA, as one of only two Federally-operated school systems, is responsible for planning, directing, coordinating, and managing prekindergarten through 12th grade educational programs on behalf of the Department of Defense (DoD).

What is a DoDEA form 5013?

DoDEA Form 5013, Verification of Professional Educator Employment for Salary Rating Purposes.

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