Athletic Physicals Night


Fairfield Community School District

Activities Department

605-607 East Broadway Avenue

Fairfield, Iowa 52556

Telephone (641)472-2059                       Facsimile (641)472-0238

FCSD, in conjunction with the JCHC Clinic, will be offering athletic physicals at a discounted rate of $25.00 (cash or check only…no credit cards or debit cards will be accepted).  If you plan to participate in any athletic activities, you will require a current physical and should attend the following session to be held at the Jefferson County Health Center Clinic. 

We will only be having one physical night again this year. Boys and girls will be seen on the same night.


Thursday, August 1, 2019 - 5:30 - 6:15 p.m. for High School Students

Thursday, August 1, 2019 - 6:15 – 7:00 p.m. for Middle School Students

   If you do not attend this session, you will be responsible to schedule an appointment through your doctor’s office and forward a copy of your physical to the Activities Office.  Athletes will NOT be allowed to practice without a current physical and signed concussion form on record with the Activities Office.

   A physical form is included with this letter so that the student’s medical history and all other pertinent information is completed prior to physical.    Parents MUST sign this formThe physicians will not see students without a signed and completed form.

 You will also find a medical consent form and a concussion form that need to be completed and signed by the student’s parent or guardian.  Please deliver these forms to the medical clinic at the time of “physical night” or to the Activities Office at the high school. 

Your student must have these forms completed, signed and turned into the activities office prior to sport practice/game participation and/or travel. 

 Additional physical forms are available at the Activities Office at the high school and will be available at the above-referenced medical clinic.