AGENCY: Department of Health. Bureau of Health Promotion
SERIES: 81911
TITLE: Pre-athletic interim health questionnaire
DATES: 1985-
ARRANGEMENT: alphabetical by school district
DESCRIPTION: This is a parental consent form to allow a student to continue to participate in interscholastic athletics without a second physical examination. This report is sent to the state for statistical purposes. This form includes the student's name, date of birth, school, and date of last physical examination; any changes to the student's health since the last physical; and the signature of the parent.
RETENTION
Retain for 1 year(s)
DISPOSITION
Destroy.
RETENTION AND DISPOSITION AUTHORIZATION
Retention and disposition for this series were specifically approved by the State Records Committee.
APPROVED: 06/1987
FORMAT MANAGEMENT
Paper: Retain in Office for 1 year and then destroy.
APPRAISAL
Administrative
This record is a duplicate copy. The original is kept in the school's athletic files. This record therefore has only administrative value.
PRIMARY DESIGNATION
Private