Prospective Student Athlete Health History Questionnaire

Form Template

Here are some questions asking in this Prospective Student Athlete Health History Questionnaire.

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Has a physician ever denied or restricted your participation in sports due to any heart problems? Have you ever had an electrocardiogram (EKG) and/or echocardiogram of your heart? Do you have only one of two paired, functioning organs (eyes, kidney, ovary, etc.)? Have you ever had seizures or convulsions? Do you or anyone in your family have sickle cell trait or disease? Have you had a viral infection (i.e. mononucleosis, myocarditis, etc.) within the past six (6) months? Have you ever been told by a physician to restrict your sports activity or not to participate in a sport? Are you aware of any reasons why you should not participate in intercollegiate athletics at UCF at this time?

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