Forms
Pre-participation Physical Examination
ARTICLE VII 36.14(1) PHYSICAL EXAMINATION. Every year each student (grades 7-12) shall present to the student’s superintendent a certificate signed by a licensed physician and surgeon, osteopathic physician and surgeon, osteopath, advanced registered nurse practitioner (ARNP), physician’s assistant or qualified doctor of chiropractic, to the effect that the student has been examined and may safely engage in athletic competition. This certificate of physical examination is valid for the purposes of this rule
for one (1) calendar year. A grace period, not to exceed thirty (30) days, is allowed for expired certifications of physical examination.
Concussion Information
What is a Concussion?
A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth.
Health care professionals may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, their effects can be serious.
For more information, visit the CDC's website about concussions: Injury Prevention & Control: Traumatic Brain Injury
All students in grades 7-12 who participate in extracurricular interscholastic activities must read and sign the concussion form before they are allowed to practice or compete.
Heads Up: Concussion in High School Sports
Acknowledgement Form
In addition to the pre-participation physical and the Heads Up Concussion form, all students and their parents must read and sign a North Tama Acknowledgement Form.
You are acknowledging that you have read the Heads Up Concussion form, that you have read and agree to abide by the Good Conduct Code, and that you have or are purchasing school insurance for your student.
