Introduction: æA preparticipation physical examination (PPE) is a medical history and physical examination that is administered to an athlete before participation. æIt detects conditions that predispose athletes to injuries or death. æThe United States does not currently have a mandated standard for PPEs. There is a published standard composed by renowned American medical societies. æReviews of literature show no national analysis of recommended PPEs to the published standard. æThere are variations to the quality of PPEs. æEffective PPEs can prevent injury and death as well as decrease the financial impact of injury on the American healthcare system. æææObjective: Determine if PPEs currently used in high schools across the nation are up to the published standard. ææMethods: æA total of 141 PPEs were downloaded from public and private high schools as well as national and state governing bodies. æSamples are graded on a 4 point grading scale and a yes/no scale developed by the researchers. The rubric was derived from the published standard created by the national consortium of experts. æGraded, the published standard receives a perfect score of 301. æSample scores were compared to the sectional and overall scores of the published standard. Results: Inter-rater reliability was calculated to be 88% agreement. æPreliminary analysis demonstrates 72% of the sample as not meeting the minimum standard. æææConclusion: The results suggest a vast majority of stateÍs PPEs did not meet the published standard. The inconsistency and lack of quality PPEs lead to injury, death and increased healthcare costs in athletics.