Pre-participation Physical Examinations at The University ...
Pre-participation Physical Examinations at The University of West Alabama
Saturday, July 25, 2020
SCHOOL NAME:______________________________________________ TELEPHONE # (_______)______________________
ADDRESS:_________________________________________ website________________________________________________
__________________________________________________________________________________________________
City State Zip
HIGH SCHOOL
CONTACT PERSON:_________________________________POSITION:_________________eMail:_______________________
TELEPHONE # Work_____________________________# Cell________________________ Home_________________________
Please list the approximate number of athletes expected to be sent to UWA for Physical Examinations:
_____Football _____Track _____Baseball _____Soccer _____Tennis ______Cheerleading
_____Basketball _____Volleyball _____Softball _____Golf _____Other
Preferred Time for Your Team to Arrive to begin Physical Examinations: (Circle One)
8:00 A.M. 8:15 A.M. 8:45 A.M. 9:15 A.M. 9:45 A.M. 10:15 A.M.
____________________________________ Coaches name that will accompany athletes to UWA for physical examinations.
Remember: It is essential that each athlete desiring a pre-participation physical examination bring a medical history/physical examination form signed by their parents/guardian and be dressed in t-shirts and shorts.
Return to R.T. Floyd, Station #14, The University of West Alabama, Livingston, AL 35470 or email to rtf@uwa.edu by July 21, 2020.
Pre-participation Physical Examinations at The University of West Alabama
Saturday, July 25, 2020
SCHOOL NAME:______________________________________________ TELEPHONE # (_______)______________________
ADDRESS:_________________________________________ website________________________________________________
__________________________________________________________________________________________________
City State Zip
HIGH SCHOOL
CONTACT PERSON:_________________________________POSITION:_________________eMail:_______________________
TELEPHONE # Work_____________________________# Cell________________________ Home_________________________
Please list the approximate number of athletes expected to be sent to UWA for Physical Examinations:
_____Football _____Track _____Baseball _____Soccer _____Tennis ______Cheerleading
_____Basketball _____Volleyball _____Softball _____Golf _____Other
Preferred Time for Your Team to Arrive to begin Physical Examinations: (Circle One)
8:00 A.M. 8:15 A.M. 8:45 A.M. 9:15 A.M. 9:45 A.M. 10:15 A.M.
____________________________________ Coaches name that will accompany athletes to UWA for physical examinations.
Remember: It is essential that each athlete desiring a pre-participation physical examination bring a medical history/physical examination form signed by their parents/guardian and be dressed in t-shirts and shorts.
Return to R.T. Floyd, Station #14, The University of West Alabama, Livingston, AL 35470 or email to rtf@uwa.edu by July 21, 2020.
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