State of Hawaii “Physical Examination for Athletes” - Basic ‘High School Sports Form’ accepted by all public schools in the state of Hawaii.

1. Print out Physical Examination for Athletes Form (Link Below)

2. The first two pages, “Concussion Management” do not need to filled out by your physician.

3. The last two pages, “Physical Examination for Athletes,”need the following filled out before you bring us the form: The top half of the first page, which has student identifying data, and, the top of the last “Parent/Guardian and Student to fill…” page.

4. Ideally we will provide this form free of charge at the time of your child’s visit if you request it. If this opportunity has been missed, please confirm that there was a physical within the last year (365 days). If you are not sure of this, please check MyChart or call the office to confirm this before dropping off the form.

5. We will do our best to fill out the form at the time of drop off but it can take up to 3 business days if we are busy.

6. If you

Alternatively, if you prefer to have our team print the form, fill out our part, and have it ready for you to pick up at the office, please purchase this service with the link below. Unfortunately, this form has a parent section that we will need to review so it must be picked up at the office and parent section completed before we can sign off on the form. There is a $10 fee for this service. Please allow us up to 3 business days to complete this service.