CorupReneNSrvE lrurrteu Pne-PenlctpATtoN PnysrcRl- Evnlurror.r eruo CenlFtcATtoN or AurHoRtzED Meotcal Exlrvllruen Must be completed and signed by the Authorized Medical Examiner (AME) performing the herein named student's cornprefrensive initial pre-pa(icipation physical evaluation (CIPPE) and turned in to the Principal, or the Principal's designee, of the student's school.
Age-
Student's Name
School
Enrolled in
Height
Weight
% Body Fat
(optional)
Grade-
Sport(s)
BrachialArtery
BP
/
(____J_,
/
) Rp
lf either the brachial artery blood pressure (BP) or resting pulse (RP) is above the following levels, further evaluation by the student's primary care physician is recommended. Age 10-12: BP:>126182, RP: >104; Age 13-15: BP: >136/86, RP >100; Age 16-25: BP:>142t92, RP >96. Vision: R 20/_ L20l_ Corrected: YES NO (circle one) Pupils: Equal_ Unequal_
Neck Back Shoulder/Arm Elbow/Forearm WrisUHand/Fingers Hip/Thigh Knee Leg/Ankle Foot/Toes I hereby certify that I have reviewed the HenlrH HrsroRy, performed a comprehensive initial pre-participation physical evaluation of the herein named student, and, on the basis of such evaluation and the student's Heelrn HrsroRv, certify that, except as specified below, the student is physically fit to participate in Practices, lnter-School Practices, Scrimmages, and/or Contests in the sport(s) ccnsented to by the student's parenUguardian in Section 2 of the PIAA Comprehensive lnitial Pre-Participation Physical Evaluation form:
il
CLEARED
n
NOT CLEARED for the following types of sports (please check those that apply):
D Cour-tstott
il
CLEARED, with recommendation(s) for further evaluation or treatment for:
(____J_, / Vision: R 20/_ L20l_ Corrected: YES NO (circle one) Pupils ...
n NOT CLEARED for the following types of sports (please check those that apply):. D Cour-tstott I Corurecr I Norl-corurncr I Srneruuous I-l MoDERATELy ...
Must be completed and signed by the Authorized Medical Examiner (AME) performing the herein named student's cornprefrensive initial pre-pa(icipation ...
Negotiations Saying yes/ no/ maybe simplest responses card game and key words. Listen to .... Test each other on that language in some or all of these ways:.
For all thy gifts we thank thee God, especially for the gift of friendship and the privilege of service. Aims & Objectives of Ladies Circle. 1) To be non-political and non-sectarian. 2) To promote friendship between Circlers and Tablers' wives Locall
That is absolutely my last word on this matter./ This is absolutely funda- mental/ crucial/ vital. I'm sure you don't (really/ honestly) expect us to acceptâ¦/ There's ...
Download now. Click here if your download doesn't start automatically. Page 1 of 1. the hobbit j r r tolkien pdf. the hobbit j r r tolkien pdf. Open. Extract. Open with.
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lying instead on local Euclidean distances that can be mis- leading in image space. .... 0 means the pair is parallel (aligned) and 1 means the pair is orthogonal ...
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Ferrand (1994) at the 35th Annual Meeting of the Psychonomic Soci- ety, St. Louis. .... mask was presented on the center of the screen for 500 msec. This ..... simonious interpretation is that the sharing of the response code between prime and ...
All Orders, circulars, memoranda contrary to or inconsistent herewith are hereby. modified and all concerned should be guided accordingly. This Order takes effect immediately. JOSE I ID O N. CAMACHO. 41 W14 t0-Vopiftil. PHILIPPINES. "Tulong-tulong sa
Ministers PEDRO M. ALMANZOR and ALFREDO PIO DE RODA, JR. were. authorized to sign official communications for the signature. of Minister Cesar Virata ...
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Page 1 of 60. Bohol Profile. Bohol. Basic Facts. Geographic Location Bohol is nestled securely at the heart of the Central. Visayas Region, between southeast of Cebu and southwest. of Leyte. Located centrally in the Philippine Archipelago, specifical
realized during the last four (4) consecutive calendar years (1982-. 1985), as certified by the Commission on Audit under its letter dated. January 29, 1987.