Printable Forms

ATHLETIC PRE-PARTICIPATION 
PHYSICAL EXAMINATION FORMS

PHYSICAL EXAM FORM 
The Physical Exam Form is valid for one year from date of exam.
COMPLETED CARDIAC ASSESSMENT PROFESSIONAL DEVELOPMENT MODULE - Your child's Pediatrician will need to sign that he/she has completed this module. 
 
Health History Update Questionnaire 
Each student whose physical examination was completed more than 90 days prior to the first day of official practice shall provide a health history update questionnaire completed and signed by the student’s parent or guardian.
                      
 
Sports-Related Concussion and Head Injury Fact Sheet and Parent/Guardian Acknowledgement Form 
To be completed electronically. This form must be reviewed and electronically submitted by both parent/guardian and athlete prior to athletic participation.
 
Sportsmanship Contract / Substance Abuse & Tobacco Policy -
To be completed electronically.
This form must be reviewed and electronically signed by both parent/guardian and athlete prior to athletic participation. This form is also required for all extra/ Co-Curricular Clubs/Activities.       
 
NJSIAA Steroid Testing Policy / Consent to Random Testing -
To be completed electronically.This form must be reviewed and electronically signed by both parent/guardian and athlete prior to athletic participation. 
  
Sudden Cardiac Death in Young Athletes:  
This is a brochure published by the American Academy of Pediatrics. To be completed electronically. This form must be reviewed and electronically submitted by both parent/guardian and athlete prior to athletic participation.    
Sudden Cardiac Death in Young Athletes Brochure   
 

Administration of Over-the-Counter and Prescription Medications
          (Form to be completed by both parent and physician)
Students must submit updated MD/parental permission and supply of medication with each new school year.

All medication(s) will be discarded at the end of each school year, unless permission to release is provided. 
Students must submit updated MD/parental permission and supply of medication with each new school year.
 
This form is to be completed by both parent and physician
 
Emergency Contact and Information Form 
To be completed electronically. This form needs to be completed via Parent Access at the beginning of each school year. Attempts to notify parents will always be done prior to contacting any of the additional contacts provided. 

Exempt from Screening
If a student has not been screened by their private physician the School Nurse will screen the following:
9th grade - All students are required to be screened by their private physician.
10th grade - Height, Weight, Blood Pressure, and Vision 
11th grade - Height, Weight, Blood Pressure, Hearing and Scoliosis
12th grade - Height, Weight, Blood Pressure
Screenings will be conducted during the school year.  Any student that wishes not to be screened for any of the above will need to provide the attached exemption, signed by their parent/guardian.
 
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