Most American students must pass a preparticipation physical before joining a school team. Many families treat it as the year's health visit, which it is not designed to be.
The exam has a narrow purpose
Its object is to identify conditions that would make participation unsafe, and to flag issues needing evaluation before an athlete is exposed to exertion and contact.
The history questionnaire does much of the work, asking about prior injuries, fainting, chest symptoms with exercise, family cardiac history, asthma and previous concussions.
Because the questionnaire carries so much weight, it is completed accurately or it is not useful, and a parent guessing at family history undermines the whole screen.
What it is not built to cover
Routine preventive care includes immunizations, vision and hearing, mental health screening, discussion of nutrition and confidential conversation about matters an adolescent may not raise with a parent present.
A sports physical performed quickly in a gym setting cannot accomplish that, and it is not intended to. It answers one question about participation.
Families who substitute one for the other lose the annual visit where those other topics are normally addressed, and the loss is silent because a form was signed.
Setting changes what can be discussed
Mass screenings held at a school are efficient and inexpensive, and they involve limited privacy and no continuity with a clinician who knows the athlete.
An examination with a regular clinician allows questions about menstrual health, disordered eating, sleep and mood that an athlete is unlikely to raise in a line of teammates.
Confidentiality rules for adolescent care vary by state and by topic, and asking directly what will and will not be shared is a reasonable question at the start of a visit.
Clearance is not a guarantee
Clearing an athlete means no disqualifying condition was identified through this screen, not that no condition exists or that injury will not occur.
Some serious conditions are not reliably detectable through history and examination alone, and screening protocols reflect a considered balance rather than an ability to catch everything.
Requirements differ by state
Which form is used, how often it must be repeated, who may perform it and what disqualifies participation are set by state associations and change over time.
A pediatrician or family physician is the person to ask about an individual athlete, and any symptom occurring during exertion warrants evaluation regardless of when the last form was signed.