Physical Education Short-term Illness or Injury Restriction Report

This form should be considered for completion if an authorized health care provider has indicated that a student’s physical activity should be restricted in physical education classes. The authorized health care provider may use this form to specify the nature and duration of the restriction.

Physical Education Short-term Illness or Injury Restriction Report	834 K	English
Reporte de Restricción de Educación Física a Corto Plazo Debido a Enfermedad o Lesión	425 K	Spanish
Rapport de restriction d'activités en cours d'éducation physique due à une maladie bénigne ou une blessure	425 K	French
Báo Cáo Hạn Chế Sinh Hoạ t Thể Thao do Bệnh Tật hoặc Chấn Thương Ngắn Hạn	480 K	Vietnamese
體育課短期疾病或受傷限制報告	514 K	Chinese
질병 또는 상해에 의한 체육 단기 제한 보고 양식	460 K	Korean
የሰውነት ማጎልመሻ ትምህርት ለአጭር ጊዜ ህመም ወይም የአካል ጉዳት የመታገድ-የመገደብ ሪፖርት	455 K	Amharic

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