PIAA CIPPE/Sports Packet Information
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- Paperwork Directive: PIAA Sport Forms Packet
- ImPact Testing
- Instructions for Completing PIAA Form
- Procedures for Submitting PIAA Sports Forms
- Additional Information
Paperwork Directive: PIAA Sport Forms Packet
Paperwork Directive: The 2024-25 PIAA Sports Forms packet consists of the PIAA Comprehensive Initial Pre-Participation Physical Evaluation (CIPPE) paperwork, an updated Assumption of Risk & Parent/Student Guidelines form, and the ImPact Consent forms. Submissions must include a CIPPE Section 6 (Physician Certification) dated after May 1, 2024.
- FALL 2025: submit in PowerSchool CIPPE Sections 1,2,3,4,5,6, the Risk & Guidelines (10) and the ImPact Consent forms (11) for 1st sport. Complete Section 7 for 2nd or 3rd sport.
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FIRST sport WINTER or SPRING 24-25: submit CIPPE Sections 1,2,3,4,5,6, the Risk & Guidelines (10) and the ImPact Consent (11) forms. See dates below.
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Injuries: If an athlete was injured, and unable to participate since last certified by a physician, a CIPPE Section 8 will also be required.
If you have any questions about paperwork, please contact Debbie Chiarello. Previous versions of this paperwork will not be accepted.
ImPact Testing
Impact Testing: Students will be informed via TESD EMAIL if an ImPact baseline test is required after Complete Sports Forms are submitted and reviewed. ImPact baseline tests will be administered at home for the foreseeable future. Please direct any ImPact questions to Justin Bruckner or impacttest@tesd.net.
Instructions for Completing PIAA Form
- Logon to PowerSchool (http://powerschool.tesd.net)
- Click on TESD FORMS
- Complete the eight-part form in its entirety and hit SUBMIT. (Sections 1,2,3,4,5,6,10,11)
- Link to printable health history form to be filled out by a physician (section 6) https://www.tesd.net/cms/lib/PA01001259/Centricity/Domain/16/PIAA_Section_6_20230523.pdf
- Upload physical form in PIAA section 6
Procedures for Submitting PIAA Sports Forms
Options/procedures for submitting the PIAA Complete Sports Forms:
*All Athletes must submit the Conestoga High School Parent/Guardian Assumption of Risk and Acknowledgement of Guidelines Signature Form. This form must be signed in accordance with the Rules and Guidelines, School Board Policy and the Concussion and Cardiac Arrest information available below.
**All students must complete the Impact Consent Form. However, students are tested on a two-year cycle. If a student was tested in the past two years, they do not need a new Impact Baseline Test.
- The Athletic Trainers will schedule impact testing for those students that may require one with the students directly.
- Fall Sports that require an ImPact baseline test: Football-Soccer-Cheerleading-Field Hockey-Volleyball-Ice Hockey.
- Winter Sports that require an ImPact baseline test: Basketball-Wrestling-Diving
- Spring Sports that require an ImPact baseline test: Lacrosse-Baseball-Softball
PIAA Comprehensive Initial Pre-Participation Physical Evaluation (CIPPE) explained:
- Section 1: Personal and Emergency Information sheet.
- Section 2: Certification of Parent/Guardian signed next to the sport the student intends to play, as well as where indicated in parts “B” through “F”
- Section 3: Understanding of Risk of Concussion and Traumatic Brain Injury
- Section 4: Understanding of Sudden Cardiac Arrest Symptoms and Warning Signs (NEW 2020)
- Section 5: Health History to be completed by parent/guardian
- Section 6: PIAA Comprehensive Initial Pre-Participation Physical Examination and Certification of Authorized Medical Examiner.
- Section 7: Parent Re-Certification form. By completing this form, the parent or guardian is assuming responsibility that the student’s health is unchanged since he/she was seen by a physician. This form must be completed if the physical has been performed before.
- Section 8: Physician Re-Certification form. This form is only needed if an athlete has been under physician’s care for an injury or illness since their physical (Section 6).
**NOTE: The misrepresentation of student health information can lead to harmful consequences. Any misrepresentation of a student’s medical status, by either the student or the parent or the guardian, will result in a season’s suspension from interscholastic sports participation**
Additional Information
Additional Sports Information is available below for review:
- School Board Policy 5422: Student Accidents and Injuries-Treatment and Reporting
- School Board Regulation 5422: Student Accidents and Injuries-Treatment and Reporting
- School Board Regulation 6146: Student Athletics
- Sudden Cardiac Arrest Symptoms and Warning Signs Information Sheet and Acknowledgement of Receipt and Review Form (Attachment A)
- Concussion Information Sheet and Acknowledgement Form (Attachment B)