Every year several thousands of preparticipation physical examinations (PPE) are performed for high school athletes. The main goal is to provide health and safety for the high school athletes. A 1997 monograph sets forth recommended guidelines for the PPE. The objective of this paper is to review the monograph and compare it to the current practice within Oklahoma. The form provided by the Oklahoma Secondary School Activities Association lacks proper screening questions, especially for cardiac disease and exercise induced asthma. The recommendations in the monograph provide an excellent foundation from which uniform guidelines can be developed. Oklahoma should strongly consider adopting the monograph's form or updating the current form.