This year we are again pleased that free sports physicals will be offered through Kaiser Permanente at Summerfest. Attached are the required forms in English and Spanish. Any student wanting to obtain a sports physical must have a parent/guardian sign the consent form and bring it with them to Summerfest. The Parent/Guardian signing the form must also be present. The physical evaluation form should also be brought to the physical clinic by the student. The first page of the 3 page physical examination form is filled out by the student prior to the physical; the second page is completed by the doctor. The third page is the clearance, again, filled out by the doctor. All three pages would be given to the student at the end of the physical and they would be responsible for getting the clearance to their school/coach. The student keeps the first two pages. The third page of the evaluation form (medical clearance) will be given to the student to take to their school. A copy of the clearance form will also be kept by VUSD. Please make sure you print these forms for any athletes who want to take advantage of this clinic. If your school site requires its own clearance form please make sure that student athletes know this and bring the required form with them.


The physicals will be held in the La Petite daycare building at the ESC starting at 9:00 a.m. You should make sure that all student athletes know who they are supposed to submit their clearance form to at your site. Please make sure this information is distributed to all coaches so they can notify their athletes.


Thank you and thanks to Kasier Permanente for offering this service!


Physical Evaluation Form SP 5.21.16

Physical Evaluation Form 5.21.16

Parental Consent-physical-Kaiser SP 5.21.16

Parental Consent-physical-Kaiser 5.21.16