2015-2016 Sports Physicals

Prior to participating in any PIAA sport in the Middletown Area School District, students are required to complete a PIAA Comprehensive Initial Pre-Participation Physical Evaluation (CIPPE). The CIPPE form, sections 1, 2, 3, 4 and 5 must be completely filled out and signed by the parent or guardian before the doctor will examine the student and fill out section 6. No student will be allowed to participate in athletics during the PIAA season without the entire 6-page CIPPE packet completed. In accordance with the PIAA, physicals cannot be dated earlier than June 1, 2015 and will be effective for the entire school year, until May 31, 2016. The CIPPE form is available at the Middle School and High School offices or can be found under “Documents and Forms” in the right column of this page.

Sections 7 and 8: for subsequent sport(s) in the same school year, a student must complete Section 7 of the CIPPE form and turn it in to the school before participating in additional sports during the 2015-2016 school year. The medical staff at MASD also requires that ANY ATHLETE having a CIPPE exam more than 6 weeks prior to the start of their sports season, must complete the Section 7 form, regardless of whether they played a sport in the previous season. The medical staff at MASD may require any athletes with a significant change in their medical history since their initial exam, to complete a CIPPE Section 8 form. This form is a medical recertification form that must be completed by the athlete’s physician.

Any students considering playing a sport for the upcoming 2015-2016 school year should attend the School District free CIPPE exam during the summer of 2015. MASD will only be offering the CIPPE exams during the dates and times listed below. ATHLETES MUST BRING THEIR COMPLETED PHYSICAL PACKET WITH THEM FOR THEIR EXAM. Athletes planning to attend the District exam must register online for an appointment. Appointment times can be chosen up until the day before the physical date. To pick a time slot for one of the below dates, click here and use the Entry Code: RJH193867. Students not attending the free exam offered by the District will be responsible for seeing their own family doctor to have the exam completed.


June 4, 2015
6:00 – 9:00 p.m. at Middletown Area High School Gym
August 5, 2015
6:00 – 9:00 p.m. at Middletown Area High School Gym

All completed forms must be returned directly to the School Nurse prior to the beginning of the season.

Questions can be directed to Athletic Trainer, Suzanne Bologa, at sbologa@raiderweb.org.