Sports Physicals

Sports Physicals POST BANNER2

Prior to a student participating in any PIAA sport in the Middletown Area School District (MASD), the student is 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, 2016 and will be effective for the entire school year, until May 31, 2017.

Sections 7 and 8:  For subsequent sport(s) in the same school year: The medical staff at MASD requires that 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. The medical staff at MASD may 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 2016-2017 school year should attend the school district free CIPPE exam on July 26, 2016 or August 4, 2016. MASD will only be offering the free CIPPE exams during these dates and times, as listed below. Students not attending the free, District paid exam will be responsible for seeing their own family doctor to have the exam completed.

Free CIPPE Exams: The dates, times and locations for free CIPPE exams are as follows:

July 26, 2016: 6:00-9:00 p.m. at Middletown Area Middle School Gym
August 4, 2016: 6:00-9:00 p.m. at Middletown Area Middle School 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 PYF1138718.

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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