Medium

Available on

Apple Android Windows

Urgent Care Sports Physical Form Mobile App

The Urgent Care Sports Physical Form mobile app makes it easy for physicians to complete school sports physical forms using a smartphone or tablet. The app can easily be made HIPAA compliant. Check out other Urgent Care Apps in our App store.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Urgent Care Sports Physical Form Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico date

    Date

  • Ico textbox

    Name

  • Ico multiline

    Address

  • Ico textbox

    Phone

  • Ico dropdown

    Sex

  • Ico integer

    Age

  • Ico date

    DOB

  • Ico textbox

    School

  • Ico integer

    Grade

  • Ico textbox

    Sport

  • Ico statictext

    Check if YES.

  • Ico checkbox

    Has a doctor ever restricted/denied your participation in sports?

  • Ico checkbox

    Have you ever been hospitalized or spent a night in a hospital?

  • Ico checkbox

    Have ever had surgery?

  • Ico checkbox

    Do you have any ongoing medical conditions (like Diabetes or Asthma)?

  • Ico checkbox

    Are you presently taking any medications or pills (prescription or over-the-counter?

  • Ico checkbox

    Do you have any allergies (medicine, pollens, foods, bees or other stinging insects)?

  • Ico checkbox

    Have you ever passed out during or after exercise?

  • Ico checkbox

    Have you ever been dizzy during or after exercise?

  • Ico checkbox

    Have you ever had chest pain or discomfort in your chest during or after exercise?

  • Ico checkbox

    Do you tire more quickly than your friends during exercise?

  • Ico checkbox

    Have you ever had high blood pressure?

  • Ico checkbox

    Have you ever been told that you have a heart murmur, high cholesterol, or heart infection?

  • Ico checkbox

    Have you ever had racing of your heart or skipped heartbeats?

  • Ico checkbox

    Has anyone in your family died of heart problems or a sudden death before age 50?

  • Ico checkbox

    Does anyone in your family have a heart condition?

  • Ico checkbox

    Has a doctor ever ordered a test on your heart (EKG, echocardiogram)?

  • Ico checkbox

    Do you have any skin problems (itching, rashes, sta ph, MRSA, acne)?

  • ...and More!

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