Wisconsin Preparticipation Physical Evaluation Form 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the student's name, date of birth, age, sex, grade, and school information in the designated fields. Ensure all details are accurate for proper identification.
3. In the clearance section, select the appropriate option regarding the student's physical evaluation status: 'Cleared without restriction', 'Cleared with qualifications', 'Not cleared', or 'Pending further evaluation'.
4. Fill in any specific sports restrictions if applicable and provide reasons for non-clearance if necessary.
5. The physician must complete their information including name, signature, clinic details, and date of examination. This ensures that all medical evaluations are properly documented.
6. Parents should fill out their place of employment and insurance information. Additionally, provide emergency contact details and any relevant medical history such as allergies or medications.
7. Finally, ensure that both parent/guardian signatures are provided along with the date to validate consent for participation.

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