Physical Education Risk Assessment Form
Assess student readiness for physical education activities and record participation guidance using the Physical Education Risk Assessment Form.
Student and Activity Details
Student's Full Name
*
First Name
Last Name
Grade Level or Class Group
*
Teacher or Coach Name
*
First Name
Last Name
Date of Assessment
*
-
Month
-
Day
Year
Date
Physical Education Activity or Unit
*
Risk Assessment Inputs
Recent injury or discomfort status
*
None
Minor concern
Needs review
Other
Activity-specific risk factors
Balance concerns
Fatigue
Reduced mobility
Asthma or breathing concerns
Recovery from injury
Other activity limitations
Overall readiness and safety to participate
*
Low readiness
1
2
3
4
5
6
7
8
9
Fully ready
10
1 is Low readiness, 10 is Fully ready
Additional notes or teacher observations
Final Assessment Outcome
Final participation recommendation
*
Full participation
Modified participation
Do not participate today
Follow-up action or support plan
Submit
Should be Empty: