WEST ALLEGHENY HIGH SCHOOL

ATHLETIC DEPARTMENT

TO: Parents of Students

FROM: David G. McBain, CAA, ATC, LAT

Director of Athletics

RE: Physical Exams for Athletic Activities

In preparation for the upcoming athletic seasons at West Allegheny, the following must be understood and completed. The PIAA has made some changes in the documentation for physicals. Please understand that one physical per athletic year may be given and cover the athlete provided there are no orthopedic or medical conditions that required time loss or outside medical intervention. The recertification forms must be filled out in their entirety after the initial exam for any subsequent seasons in the same academic year. If there are any remarks that an athlete has had a medical issue since the initial physical then they must have the recertification page filled out by their attending physician or receive another exam from our school physician. Sections 1, 2, 3, 4, 5 and 7 must be filled out for the next sports season.

Wrestling is unique to this process for both the high school and junior high levels. Please contact the athletic office in order to understand the mandated demands for paperwork.

Please note: to avoid any confusion all sections for each season must be reviewed and those required must be completed and returned. If your child is involved with wrestling you would also need to complete section eight (8). If you are unsure as to what forms are needed please call the Athletic Office for verification.

It is important to remember that the exams are given by our school physician and they can become COMPREHENSIVE in nature. The exam may include various components based on verbal or written history and/or physical presentation. Please talk with your child prior to the exam what the format may consist of so there are no unnecessary surprises and to maintain mutual respect for the exam process. Information necessary to provide adequate medical care in the event of any emergency will be kept in accordance with HIPAA regulations.

**NEW FOR 2012-13** There is a two new sections that requires both student and parent signatures that deal with the information surrounding concussions and sudden cardiac arrest. Both parent and student MUST sign those signature lines or the form will not be accepted.

Reminders:

Ø  Please complete the form in its entirety, especially ANY parent signature lines. Please print legibly especially on the emergency information page.

Ø  Please call the Athletic Office with any questions.

Ø  Do not give this form to your child’s coach. Delaying the process may result in needing a recertification exam prior to the next season and having the review delayed. Drop it off in the Athletic Office or high school office.

Ø  Extra forms may be downloaded off the Athletic Department web site: www.westalleghenyathletics.com

Concussion Management Information

The Safety In Youth Sports Act Becomes Law in PA on July 1, 2012

Two Key Elements:

·  Student-athletes and their parents or guardians must sign an acknowledgment of receipt of an information sheet on concussions prior to participation in athletics. This is section 3 of the CIPPE form:

SECTION 3: UNDERSTANDING OF RISK OF CONCUSSION AND TRAUMATIC BRAIN INJURY

·  It will require coaches to complete a concussion management certification training course before coaching any athletic activity.

On the Pennsylvania Athletic Trainers’ Society (PATS) website link below athletes and parents can take a free course to better understand the basics of a concussion. Go to either www.gopats.org or to http://concussionwise.com/pennsylvania

ConcussionWise Pennsylvania

Sport Safety International has partnered with the Pennsylvania Athletic Trainers' Society to offer the ConcussionWise series of educational programs. These programs have been peer-reviewed and are consistent with the latest science and practical applications regarding the prevention and management of concussion.

Top of Form

Bottom of Form

Top of Form

Top of Form

ConcussionWise SPORT for Athletes

Bottom of Form

As an athlete, it's likely that you are aware of the recent focus on concussions in sports. It is important for athletes to understand concussion basics, as well as steps to prevent and properly care for concussions when they occur.ConcussionWiseSPORTfor Athletesis a free online course developed specifically for athletes by Sport Safety International. At the completion of the course, viewers will have the opportunity to receive a completion certificate.

Top of Form

ConcussionWise SPORT for Parents

Bottom of Form

If you're a parent of a young athlete, it's likely that you are aware of the recent focus on concussions in sports. It is important for parents to understand concussion basics, as well as steps to prevent and properly care for concussions when they occur. ConcussionWise Sport for Parents is a free online course developed specifically for parents by Sport Safety International. At the completion of the course, viewers will have the opportunity to print a completion certificate.