I guess I'm lucky, being at a large high school in TX. Our licensed athletic trainers are in charge of sports physicals, and will exclude students from participation in athletics if a form is not on file on the first day of practice. Physicals are offered at the school in the spring, and parents have to fill out all of their information online as of this year. I work closely with the trainers to ensure all students with asthma, seizures, severe allergies, etc, have action plans and medication on file. They use a program called Sportswear to manage all of the athletes, as well as the visits the athletes make to them for injuries. I have access to their software, so I can go in and print action plans to have on file in the clinic. This is mainly for the students who self-carry their inhalers.