Completion of the medical history and physical examination form is mandatory for participation in the sports programs of this college. Please make sure that all statements regarding your personal information and medical history are complete and accurate.
There are three pages to the Medical History and Sports Physical. Please download and complete the first part of the PDF, sign, and take the form to your doctor or medical provider to complete and sign the second part of the form.
Return your filled or scanned PDF to Angela D’Amelio at angela.damelio@bellevuecollege.edu.
Medical History & Sports Physical: Fillable version
Medical History & Sports Physical:
NWAC Regulations state: “After July 1 and prior to the first practice of each year of participation in intercollegiate athletics at a member college, a student-athlete shall undergo a medical examination and be approved for intercollegiate athletic competition by a medical authority licensed to perform a physical examination by the laws applicable in the state where the exam is conducted. The physical examination shall be valid for twenty-four (24) consecutive months to the date unless otherwise limited by the physician indicating the physical is only good for less than twenty-four (24) consecutive months. Note: Those licensed to perform physical examinations in the State of Washington include M.D., Doctor of Osteopathy (D.O.), Certified Registered Nurse (C.R.N.), Naturopath (N.D.) and Physician’s Assistant (P.A.)”
Any information withheld or falsified may affect the student’s status on the athletic team and/or the student’s scholarship funding. The college reserves the right, with the student’s authorization, to request past medical records, charts and diagnoses regarding injuries, medical history or physical condition, and may request additional medical examinations or tests if indicated.
Last Updated June 17, 2025