This form was completed on the California Chapter of the ACC website using the Levine Videos for the four major CV risk questions. You should keep a copy with your family medical records and give a copy as part of your annual Pre-participation exam from your family physician and/or school.
ATHLETIC CARDIOVASCULAR HEALTH HISTORY:
Watch the videos and answer the questions. Not all questions have videos, only the first four. Please use the play button in the middle of the video to view and to stay within the questionnaire.
FAMILY HISTORY INFORMATION: