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

1. Click ‘Get Form’ to open the DoDEA Form 21 SHSM H-12-3 Sport Physical in the editor.
2. Begin by filling out the 'Completed by STUDENT' section. Enter the student's name, date of birth, and grade accurately to ensure proper identification.
3. 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'.
4. 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.
5. 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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