Sports Physicals

2017 Sports Physicals BANN

Prior students participating in any PIAA sport in the Middletown Area School District (MASD) 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, 2017 and will be effective for the entire school year, until May 31, 2018. 

  • Sections 7 and 8: For subsequent sport(s) in the same school year: ANY ATHLETE having a CIPPE exam more than 6 weeks prior to the start of their sports season, complete the Section 7 form, regardless of whether they played a sport in the previous season. In accordance with the PIAA, the medical staff at MASD will require any athletes with a significant change in their medical history since their initial exam, to have their physician complete the CIPPE Section 8 recertification form.
  • Any students considering playing a sport(s) for the upcoming 2017-2018 school year should attend the MASD free CIPPE exam on June 6 or July 31, 2017. MASD will only be offering the free CIPPE exams during these dates and times, as listed below. Students not attending the free, MASD paid exam will be responsible for seeing their own family physician to have the exam completed.
  • Appointments: In order to minimize the wait time, we request that you please sign-up for an appointment time online following the instructions listed below.
  • LOCATION: Middletown Area High School

Free CIPPE Exams:
The dates, times and locations for the free CIPPE exam offered by MASD are as follows:

June 6, 2017: Appointments beginning at 6pm in the MAHS Gym
July 31, 2017: Appointments beginning at 6pm in the MAHS Gym

Athletes should sign up online for an appointment time for one of the dates listed above. Appointment times can be chosen up until the day before each physical date. To pick a time slot, go to When you are asked for an entry code enter SXW1187813.

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. Students should bring a completed packet with them to their sports physical appointment.

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

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