PIAA PHYSICAL FORMS: (CIPPE FORM)

INITIAL PHYSICAL EVALUATION: Sections 1-6: CIPPE Form

PRIOR to any student participating in Practices, Inter-School Practices, Scrimmages, and/or Contests, at any PIAA member school in any school year, the student is required to have a completed physical, authorized by an Authorized Medical Examiner (AME)

The CIPPE may not be authorized earlier than June 1st.The Physical shall be effective, regardless of when performed during a school year, until the next May 31st.

PARENT RECERTIFICATION: Section7:CIPPE Form

PHYSICIAN RECERTIFICATION: Section 8:CIPPE Form

Section 8 of the CIPPE form is required of anystudent who subsequent to completion of Sections 1 through 6 of this CIPPE Form, required medical treatment from a licensed physician of medicine or osteopathic medicine. Section 8 may be completed at any time following completion of such medical treatment.

Wrestling Weight Certification: Section 9: CIPPE Form (1) Must be certified to by an Authorized Medical Examiner (AME)and (2) established NO EARLIER THAN six weeks prior to the first Regular Season Contest day of the wrestling season and NO LATER THAN the Monday preceding the first Regular Season Contest day of the wrestling season (See NOTE 1 under Section 9 of the CIPPE Form)

ADDITIONAL FORMS

Please fill the necessary forms in completely and sign all forms with a hand written parent signature. Forms must be return to the school athletic office or to your student's coach.