Form Instructions

PARTICIPANTS MUST BE 14 TO BE SCREENED

To complete your forms, use these links:

CONSENT FORM

HEALTH HISTORY

You will receive an email with a PDF of your form. Please print and bring this to the screening!

Due to cost, time and equipment considerations, the screening tests performed during the Play for Patrick Youth Heart Screening are NOT meant to be comprehensive or diagnostic medical quality studies. Our goal is to help identify extremely risky and imminently dangerous conditions when we can for a large number of students, but no amount of testing can give a 100% guarantee of safety. Play for Patrick Youth Heart Screening and the Patrick Schoonover Heart Foundation does not keep copies of any completed screening test images or results as they are not meant for use in a clinical setting, but more of a stepping stone for further official evaluation. If an abnormality was found during the screening, we suggest follow-up with your primary care physician and/or cardiologist.