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Canada Western Mustangs Pre-Participation Health Questionnaire

Canada Western Mustangs Pre-Participation Health Questionnaire 2026

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The document is a Pre-Participation Health Questionnaire for new athletes at Western University, designed to collect personal and medical information necessary for safe athletic participation. It includes sections on personal medical history, medications, allergies, immunizations, family history, cardiorespiratory health, neurological conditions, lifestyle factors, musculoskeletal injuries, mental health assessments (PHQ-9 and GAD-7), and consent for medical treatment. Additionally, it contains a COVID-19 Return to Sport Screening Questionnaire for athletes who have tested positive for the virus.

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Click ‘Get Form’ to open it in our editor.
Begin by entering your personal information, including your name, email, home address, and contact numbers. Ensure accuracy as this information is crucial for emergency contacts.
Complete the Personal Medical History section by answering questions regarding past medical conditions and hospitalizations. If you answer 'Yes' to any question, provide additional details in the space provided.
Fill out the Medications and Allergies section. Indicate any allergies or medications you have taken recently. This helps ensure your safety during participation.
Proceed to the Immunizations section and check off your vaccination status for various diseases. This is important for health compliance.
In the Family History section, disclose any relevant family medical history that could impact your health in sports.
Continue through sections on Cardiorespiratory health, Neurology and Concussion history, Lifestyle choices, and Musculoskeletal injuries. Provide thorough answers to ensure a comprehensive assessment.
Finally, review all entries for accuracy before signing the Medical Consent Form at the end of the document. Your signature confirms that all information is complete and truthful.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (197 Votes)
2017	4.3 Satisfied (66 Votes)

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What is the primary purpose of a pre participation health exam?

The goal of the sports physical, also known as the Preparticipation Physical Evaluation (PPE), is to promote the health and safety of athletes in training and competition. The PPE is to facilitate and encourage safe participation in sports, not to exclude athletes from participation.

What is the purpose of a pre-participation exam?

Depending on state law, the PPE examination is conducted by an MD, DO, nurse practitioner or physician assistant with clinical training to evaluate and determine medical eligibility of the athlete on a broad range of health issues.

What is a pre activity questionnaire?

Pre-exercise screening is used to identify people who may have medical conditions that put them at a higher risk of an adverse event during physical activity/exercise. Its a filter or safety net to help determine if the potential benefits of exercise outweigh the risks for an individual.

What is a pre participation questionnaire?

The PreParticipation Physical Evaluation (PPE) is a screening tool for injuries, illnesses, or underlying conditions that might place an athlete at risk during vigorous physical activity and competition.

What are the 6 parts of the preparticipation physical?

Components of the preparticipation exam. Medical History, Physical Examination, Cardiovascular Screening, Maturity Assessment, Orthopedic screening, and Wellness Screening. Medical History. Physical Examination. Cardiovascular Screening. Maturity Assessment. Orthopedic Screening. Wellness Screening. Normal Blood Pressure.

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What is a pre-screening questionnaire?

At the beginning of the prescreening interview, the interviewer typically asks general questions to learn more about your background. Hiring personnel use these questions to determine how your personality and goals fit the employer s work environment.

Canada Western Mustangs Pre-Participation Health Questionnaire 2026

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How to use or fill out Canada Western Mustangs Pre-Participation Health Questionnaire