Edit, Download, and Sign the Cornell Health 2024-25 Physical Examination Form
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How do I fill this out?
To fill out the Cornell Health Physical Examination Form, start by scheduling a physical exam with your healthcare provider. Make sure to complete all required fields accurately. Use the provided guidelines and instructions to ensure all necessary documentation is included.
How to fill out the Cornell Health 2024-25 Physical Examination Form?
1
Schedule a physical exam with your healthcare provider.
2
Complete the Physical Examination Form with accurate details.
3
Have your healthcare provider sign the form and include their contact information.
4
Attach any necessary documentation like lab reports and test results.
5
Submit the form through your Medical Clearance list or via provided fax and mail addresses.
Who needs the Cornell Health 2024-25 Physical Examination Form?
1
Entering students at Cornell University as part of their enrollment process.
2
NCAA athletes at Cornell requiring a physical exam after specific dates.
3
Students needing medical clearance for participation in intercollegiate sports.
4
Students with ongoing health concerns who need to submit current medical records.
5
Health care providers completing the form for students.
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What are the instructions for submitting this form?
Submit the completed form through your Medical Clearance list on the Cornell Health portal. If additional documentation is needed, send via fax to 607.255.0269 or mail to Cornell Health Attn: Requirements Office, 110 Ho Plaza, Ithaca, NY 14853-3101. Avoid using email for submission as it is not secure. Ensure all relevant documents, including lab reports and ongoing care records, are attached before submission.
What are the important dates for this form in 2024 and 2025?
For NCAA athletes, physical exams are required after March 1, 2024, for fall entrants or August 1, 2024, for spring entrants. Ensure to submit by the academic year 2024-25.
What is the purpose of this form?
The Cornell Health Physical Examination Form is designed to ensure that all entering students and NCAA athletes meet the health requirements necessary for participation in university programs. This form must be completed and signed by a healthcare provider, ensuring the student's physical fitness and identifying any ongoing health issues. Submission of this form is vital for the student's medical clearance, allowing them to engage in academic and athletic activities without restrictions.
Tell me about this form and its components and fields line-by-line.
- 1. Student name: Full name of the student (first, middle, last).
- 2. Date of physical exam: The date when the physical exam was conducted (mm-dd-yyyy).
- 3. GENERAL MEDICAL INFORMATION: Fields include height, weight, blood pressure, heart rate, visual acuity, and checkboxes for normal and abnormal findings in various health areas.
- 4. CLINICAL TESTS: Required only for NCAA athletes, including hemoglobin, hematocrit, sickle cell trait test, and other relevant test results.
- 5. ORGAN LOSS: Checkbox for evidence of loss of any paired organ.
- 6. HISTORY OF HOSPITALIZATION OR SURGERY: Checkbox for history of hospitalization or surgery, with space to explain if yes.
- 7. CURRENT HEALTH ISSUES: Area to provide records related to ongoing care and current medical and mental health issues.
- 8. SPORTS PARTICIPATION: Checkbox for ability to participate in all sports without restriction and space to specify recommendations for physical activity if not.
- 9. HEALTH CARE PROVIDER INFORMATION: Signature, name, address, title, and work phone of the healthcare provider.
What happens if I fail to submit this form?
Failure to submit the Cornell Health Physical Examination Form may result in the student not being cleared for university participation. This can lead to several concerns outlined below.
- Academic Delays: Students may face delays in starting their academic program.
- Athletic Ineligibility: NCAA athletes may not be allowed to participate in sports.
- Lack of Medical Clearance: Students may not receive medical clearance required for campus activities.
How do I know when to use this form?
- 1. New Student Enrollment: For all entering students to meet health requirements.
- 2. NCAA Athlete: For NCAA athletes requiring a physical exam after specific dates.
- 3. Medical Clearance: To obtain medical clearance for university activities and sports.
- 4. Ongoing Health Issues: To provide records related to ongoing care and current health issues.
- 5. Healthcare Provider Submission: For healthcare providers to document and submit physical exam details.
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Yes, you can add your digital signature using PrintFriendly's PDF editor.
Where do I upload my completed forms?
Submit your completed forms through your Medical Clearance list, fax, or mail to the provided addresses.
What documents do I need to attach with the Physical Examination Form?
Attach any relevant documentation like lab reports, test results, and ongoing care records.
Can I save my progress on the form?
Yes, you can save your progress and download the completed form once you're done.
What if I am not able to upload through the Medical Clearance list?
You can fax or mail your documents to Cornell Health using the provided contact details.
Do NCAA athletes require additional forms?
Yes, NCAA athletes must complete the Sports Clearance Form and, if applicable, the ADHD/ADD Medical Exception Form.
Will my healthcare provider need to sign the form?
Yes, a healthcare provider must sign the Physical Examination Form and include their contact information.
Where can I find the ADHD/ADD Medical Exception Form?
Download it from the provided link in the instructions section or search for it on the Cornell Health website.
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Use PrintFriendly's sharing tools to send the form via email or shareable link.
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