Physical Forms

 

ATTENTION PARENTS: If your child will be entertaining grades 7-12 and is interested in playing interscholastic or club sports for the North Hills School District please read!

Beginning with the 2019/2020 School Year (starting 6/1/19), North Hills will be using a outside provider called Healthy Roster to electronically collect all PIAA, AHN and North Hills School District paperwork as it relates to participation in extracurricular athletic activities in interscholastic and club sports for grades 7-12 only.  This includes:

  • PIAA CIPPE – Sections 1 and 2
  • PIAA CIPPE – Sections 3 and 4
  • PIAA CIPPE – Section 5
  • PIAA CIPPE – Section 6
  • PIAA CIPPE – Section 7 (if necessary)
  • AHN Sports Medicine HIPPA
  • AHN Sports Medicine Consent to Treat
  • North Hills School District Acknowledgement of Information and Release Form

~ Please note that the nurse’s physical paperwork is NOT the same as PIAA CIPPE Section 6 and will not be accepted for interscholastic and club sports participation.

All information will be filled out online using the electronic forms found in the documents section on your Healthy Roster account.  There are two exceptions:

  1. You will need to take Section 6 of the PIAA CIPPE with you to have the doctor sign off on your child’s sports physical.  Afterwards, please log on to Healthy Roster to either scan or take a picture of this document and upload to the PIAA CIPPE – Section 6 form under the documents section.
  2. You only need to fill out PIAA CIPPE – Section 7 electronically if your child is participating in more than one sport in an athletic year.  Remember this form cannot be filled out any earlier then 6 weeks prior to the start of the sports season

Finally, if you have already signed up for a Healthy Roster account you will be eligible to start filling out these documents on 6/1/19.  If you have not signed up for a Healthy Roster account or your child will be participating in athletics for the first time, please visit the link below and fill out all required information:

https://docs.google.com/forms/d/e/1FAIpQLSe4ns3NfcVp1J-W4vvCRO6qWUqqhJI-wjeY9LT8sTHjn4bPFg/viewform

Once you complete this document and submit it, you will receive an invitation from Healthy Roster to set up your account within 3-5 business days.  Once you receive the invite you will have 24 hours to set up the account before the passcode expires. After you have set up your account, you will be able to fill out all required forms listed above. Additionally, you will need to choose all of the sport(s) roster within the North Hills School District that your son/daughter is interested in.

If you need any help with completing these documents online please visit the link below:

https://hrtraining.camp/signing-a-document

If you have any questions or concerns regarding Healthy Roster, please don’t hesitate to reach out to one of our Licensed Athletic Trainers.

Danitza Nicklow MS, ATC, LAT at 412-804-8989

Eric Cardwell MS, ATC, LAT at 412-722-3619

OR you may message them via the Healthy Roster app once your account is set up.

 

FREQUENTLY ASKED QUESTIONS – HEALTHY ROSTER

Q: Can I still turn in paper copies of the mandatory forms (documents) to the Athletic Office?

A: No.  All paperwork must be submitted online via Healthy Roster.  The Athletic Office, by appointment only, can help you set up an account and walk you through the steps but all paperwork must be submitted online.   Please call 412-318-1437 to schedule your appointment.

Q: What are the mandatory forms (documents) that need to be filled out online via Healthy Roster

A: The following forms (documents) must be filled out online and signed electronically:

  • PIAA CIPPE – Sections 1 & 2
  • PIAA CIPPE – Sections 3 & 4
  • PIAA CIPPE – Section 5
  • PIAA CIPPE – Section 6 (Upload completed form only)
  • PIAA CIPPE – Section 7 (if necessary)
  • Allegheny Health Network – Authorization for Release of Protected Info
  • Allegheny Health Network – Consent to Treat
  • NHSD ACKNOWLEDGEMENT OF INFORMATION and RELEASE FORM

Q: Why can’t I fill out PIAA CIPPE – Section 6 online?

A: PIAA CIPPE – Section 6 is the actual physical that requires a physician signature, which cannot be done electronically.  To upload this form, please follow the instructions found with the PIAA CIPPE – Section 6 document in Healthy Roster.

Q: Why is PIAA CIPPE – Section 7 not mandatory for all athletes?

A: PIAA CIPPE – Section 7 is only mandatory for athletes who are playing more than one (1) sport during a school year.  This form won’t be available to complete not earlier then six (6) weeks prior to the start of the winter and spring sports season.

Q: Can I fill out the forms (documents) prior to June 1st and submit the physical after June 1st?

A: No.  All paperwork must be completed and signed after June 1st per PIAA guidelines.  All documents will be electronically dated when completed online, so you won’t be able to change the date.

Q: Do these forms (documents) need to be filled out prior to voluntary, off-season workouts?

A: No.  All paperwork is due prior to the start of the first official day of practice.  Those dates are:

  • Fall Sports – 8/12/2019
  • Winter Sports – 11/18/2019
  • Spring Sports – 3/2/2020

 Q: If I have health care  insurance other than Highmark (i.e. UPMC, Cigna, United, and Aetna), do I need to complete the Allegheny Health Network – Authorization for Release of Protected Info and Allegheny Health Network – Consent to Treat documents?

A:  Yes.  These forms are necessary for our Certified Athletic Trainers to provide treatment and care to all student-athletes in the North Hills School District.