2023-2024 SCHEDULED PIAA START DATES AND DUE DATES FOR COMPLETED CIPPE PACKETS, UPMC FORMS AND PHYSICAL EXAMS

Fall Athletics:

Due date for forms:   August 7, 2023

First day of fall sports: August 14, 2023

Winter Athletics:

Due date for forms: November 6, 2023

First day of winter sports: November 17, 2023

Spring Athletics:

Due date for forms: February 26, 2024

First day of spring sports: March 5, 2024

GENERAL GUIDELINES FOR PARENTS: CIPPE FORMS

The new PIAA physical exam packet contains several pages and it is imperative that the Parent/Guardian of the student athlete complete all sections in their entirety.  It's important that the UPMC forms are completed with this information as well.  This will allow our training staff to treat your child in case of an injury.

• Packets can be picked up in the Athletic Office, Nurses office or downloaded from pdf below
• After completing the packet-in pen- make a copy for your records and turn in the original
• No Athlete will be permitted to participate without completing the CIPPE and UPMC forms.  They must be turned into the athletic office prior to the start of the system.  

CIPPE and UPMC Packet

Athletics Code of Conduct

SECTION 1: Personal and Emergency Information

Please fill in all information regarding:

• • Emergency contact and health insurance, including policy number and phone number
  • Family physician's name, address and phone number

SECTION 2: Certification of Parent/Guardian 

Please sign beside EVERY sport your student might be interested in playing for the year

Please sign and date ALL sections A-F

SECTION 3: Understanding of Risk of Concussion and Traumatic Brain Injury

The student athlete and parents must read and understand the facts concerning concussions.

The student athlete and parents must sign and date the concussion form

SECTION 4: Understanding Sudden Cardiac Arrest Symptoms and Warning Signs

The student athlete and parents must read and understand the facts concerning cardiac arrest

The student athlete and parents must sign and date the cardiac arrest form

SECTION 5: COVID-19

The student athlete and parents must sign and date the Supplemental Acknowledgement, Waiver and Release: COVID-19

SECTION 6: Health History

Complete to the best of your knowledge as pertaining to the student athlete.  Student athlete and parents must sign and date.

SECTION 7: CIPPE and Certification of Authorized Medical Examiner

Examining physician will complete this section during physical examination.  If you choose to have the physical completed by your own doctor, please follow the steps outlined below:

• • A licensed medical practitioner must conduct exams
  • All physicals must be completed after June 1 to be eligible for the following school year's athletic programs  (i.e. Complete by June 1, 2022 for 2022-2023 school year participation) 
  • Have the physician sign, date, and fill in address/phone # at the bottom of the page
  • Please turn the completed form in as soon as possible to your coach, athletic trainer or school nurse

SECTION 8: Re-certification by Parent/Guardian

If any "Supplemental Health History" questions are answered YES, please explain at the bottom in the space provided and have your child re-certified by a licensed physician.  Please specify dates where applicable and be as descriptive as possible. 

The student athlete and parent/guardian must sign and date the form. 

SECTION 9: Re-certification by Licensed Physician of Medicine or Osteopathic Medicine

Must be completed by a physician only if you had answered YES to any of the "Supplemental Health History" questions at the bottom of the page on Section 8.

SECTION 10: Minimum Wrestling Weight

Prior to the participation by any student in interscholastic wrestling, the Minimum Wrestling Weight (MWW) at which the student may wrestle during the season must be (1) certified 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.

To treat your child, UPMC Athletic Training Services requires the following forms to be completed.  (these forms are included with the CIPPE packet at the top of this page)

• • UPMC Authorization for Release of Protected Health Information
  • UPMC Consent for Treatment and Healthcare Information
  • UPMC Privacy Practices