Who needs a medical before training, how often, and who keeps the paperwork? It depends on the country — here is how three systems differ, and a routine that works anywhere.
An athlete medical check — often called a pre-participation medical — confirms that someone is fit to train and compete. Who must have one, how often and who pays depends on where your club is. This guide compares three systems — Serbia (Clubiqo's home market, where the rules are set in law), the United States and the United Kingdom — and finishes with a record-keeping routine any club can run.
It is a practical overview for club administrators, not medical or legal advice. Always confirm the current rules with your governing body, league or local health authority.
What a pre-participation medical check is
The idea is the same everywhere: before an athlete takes on organised training and competition, a qualified professional reviews their health history and examines them. The detail — which tests, how often, who is covered — is set by national law, by a state, or by the sport's governing body.
For a club, the practical questions are always the same four: who needs a check, how long it is valid, what proof the club keeps, and what happens if someone plays without one. The answers below differ by country; the record-keeping does not.
How Serbia organises athlete medical checks
Serbia is an example of a strict, law-based model. Under Article 19 of the Sports Act (Zakon o sportu), an athlete may compete only if their general health fitness was established within the six months before the competition. The duty covers every athlete in a club's organised activities, recreational members included. A 2020 rulebook (Pravilnik 88/2020, which replaced the 2012 version) sets out the detail:
- Children aged 6–14 are examined every six months, paid for by mandatory health insurance. Above 14, the club or the athlete pays.
- Three types of check: before starting the sport, periodic checks, and a follow-up after serious illness or injury, a break of more than a year or a doping ban.
- Extra testing every six months for some groups — including competitors over 12 in high-demand sports (6 MET or more), athletes whose federation requires it, and coaches and other sports professionals.
- Four outcomes: fit, temporarily unfit, unfit, or no assessment possible — issued at the latest within 10 days and sent to the athlete, the club and the national federation.
- Federations can be stricter — Serbia's athletics federation asked for an exam no older than three months for its 2025 half-marathon championship.
| Part of the exam | What it includes in Serbia |
|---|---|
| Questionnaire | Personal and family history, including sudden cardiac death in the family before 50, medication and supplements |
| Measurements | Height, weight, BMI, blood pressure |
| Physical exam | Heart and lungs, musculoskeletal system and posture |
| ECG and bloods | 12-lead ECG with interpretation; full blood count once a year |
| Extra for high-demand sport | Lab tests and extended measurements; a yearly exercise stress test with continuous ECG for competitors over 12 in sports of 6 MET or more; yearly spirometry and echocardiography for professional, national-team and categorised athletes |
The stakes for clubs are high. Letting an athlete compete without established fitness carries a fine of RSD 500,000–2,000,000 for the club (Sports Act, Art. 175), and failing to keep records of fitness assessments RSD 100,000–1,000,000 (Art. 176). For a sense of cost, the Republic Institute for Sport and Sports Medicine lists a physical exam at RSD 600 and an ECG at RSD 700 (2025, including VAT); private clinics set their own prices.
United States: the PPE and state rules
In the US the usual term is the preparticipation physical evaluation (PPE). The reference is the Preparticipation Evaluation led by the American Academy of Pediatrics, now in its 6th edition and endorsed by organisations including the NFHS, the American Heart Association and the National Athletic Trainers' Association.
How often an athlete needs one is not set nationally. In the AAP's words, ‘the frequency of a PPE is determined by the state’. A club working with young athletes should therefore check the rules of its state and of the competitions it enters, rather than assume a national standard.
United Kingdom: governing bodies set the screening
The UK takes a different route. The UK National Screening Committee does not recommend systematic screening of 12- to 39-year-olds for the risk of sudden cardiac death — a position first taken in 2015, upheld in 2019 and proposed again in a June 2026 consultation.
Medical and cardiac screening in sport is therefore set by governing bodies and competitions; the FA's cardiac screening of academy players is one example. For a grassroots club, the practical step is to ask your governing body and league what they require, and to build that into your membership process.
| Question | Serbia | United States | United Kingdom |
|---|---|---|---|
| Who sets the rules | National law: Sports Act and Pravilnik 88/2020 | Each state, with the AAP-led PPE as the reference | Governing bodies and competitions |
| How often | Every six months | Determined by the state | Set by the governing body or competition |
| Who is covered | All athletes in a club's organised activities, recreational included | Varies by state and competition | Varies — e.g. FA academy players for cardiac screening |
A record-keeping routine that works in any country
Whatever the rules, the club's job is similar: know who is cleared, until when, and be able to prove it. A routine that does not depend on anyone's memory:
- One list, one expiry date. For every athlete, record the exam date and the date it runs out — using your local rule or your governing body's, whichever is stricter.
- A monthly check. On the first working day of each month, pull out everyone whose clearance expires in the next 30–45 days and contact them, or their parents, then — not the week before a tournament.
- Proof, not promises. Treat a check as valid only once you have seen the document. A photo is enough for the record.
- Before camps and tournaments, check the whole travelling squad against the expiry dates.
- Limit access. Medical information is sensitive. In Serbia health data is a special category under the Personal Data Protection Act; elsewhere, check your local data-protection rules and share it only with the people who need it.
How Clubiqo helps clubs track medical checks
Because Clubiqo's home market is Serbia, where these checks are a legal requirement, medical checks have their own section rather than a notes field. You enter the exam date and how many months it is valid for (1 to 6, default 6), and the expiry date is calculated for you. You can edit it by hand — for example when your governing body uses a different period.
- Clear statuses — valid, expiring soon, expired and no check — with ‘expiring soon’ shown once 30 days or fewer remain.
- A list on the web dashboard's home screen of expired checks and those expiring soon, with names and days remaining.
- Parent uploads, if the club switches them on: a parent photographs the certificate and sends it for approval. It does not count until a staff member approves it, and a rejection comes with the reason.
- Notifications to parents when a check is recorded or approved, with the date it is valid until, and when it is rejected, with the reason.
- Google Sheets sync of the medical list, with expiry dates and days remaining, daily, weekly or on demand.
One thing it does not do: Clubiqo does not send an automatic reminder when a check is about to expire. ‘Expiring soon’ is a status you see on screen, so keep the monthly check from the routine above — it simply takes less time when the expired and expiring checks are already picked out. Read more about medical check tracking and what parents see in the parent app.
Frequently asked questions
How often do athletes need a medical check?
It depends on the country and the sport. In Serbia, the Sports Act requires general health fitness established within the six months before a competition. In the US, the frequency of a preparticipation evaluation is determined by each state. In the UK, the National Screening Committee does not recommend systematic cardiac screening of 12- to 39-year-olds, so requirements come from governing bodies and competitions. Check the rule that applies to you and follow the stricter one.
Who pays for an athlete's medical check?
Again, it varies. In Serbia, mandatory health insurance covers checks for children aged 6 to 14; above that age the club or the athlete pays, and health insurance does not cover fitness certificates for sport. The Institute for Sport and Sports Medicine publishes a price list, and private clinics set their own. Elsewhere, ask your governing body or league how checks are arranged and paid for in your sport.
Do recreational members need a medical check?
In Serbia, yes: the duty covers every athlete in a club's organised activities, including recreational members. In the US and the UK it depends on the state, the governing body or the competition. Where nothing is required, decide your own club policy, write it into your membership terms and apply it consistently, so parents and adult members know what to expect.
Can parents send the medical certificate through an app?
In Clubiqo, yes, if the club switches on parent uploads. The parent enters the exam date and validity, photographs the certificate and sends it for approval. It does not count as valid until a staff member approves it. If it is rejected, the parent sees the reason and can send a new one, and the club keeps a single record instead of photos scattered across chats.
Conclusion
An athlete medical check is simple in principle — confirm that someone is fit before they train and compete — but the rules differ. Serbia sets a six-month validity in law, US states set their own frequency, and in the UK governing bodies decide. What every club controls is the record: one list with expiry dates, a monthly check and early messages to parents.
If you want those dates, statuses and documents in one place, try Clubiqo free for 14 days, no card required. Starting a club in Serbia? Read our guide on how to start a sports club in Serbia.