A Note from the Nurse
~~~ A NOTE FROM THE NURSES ~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
PLEASE NOTE THAT THE NJ STATE DEPARTMENT OF EDUCATION PREPARTICIPATION PHYSICAL EVALUATION MEDICAL ELIGIBILITY FORM NEEDS TO BE COMPLETED IN FULL BY YOUR CHILD'S PEDIATRICIAN.
IS THE ONLY FORMS WILL BE ACCEPTED.
FORMS CAN BE OBTAINED UNDER "PRINTABLE FORMS".
THE PPE MEDICAL ELIGIBILITY FORM MUST BE COMPLETED IN FULL.
INCOMPLETE FORMS WILL BE DENIED AND WILL
DELAY ATHLETIC PARTICIPATION.
THANK YOU IN ADVANCE FOR YOUR COOPERATION.
2024-2025 School Year
ALL INCOMING FRESHMAN, TRANSFER STUDENTS AND ATHLETES must have a comprehensive physical and the PREPARTICIPATION PHYSICAL EVALUATION MEDICAL ELIGIBILITY FORM needs to be completed by their Pediatrician. The completed PPE MEDICAL ELIGIBILITY FORM needs to be submitted electronically through Arbiter Sports/ Family ID
Thank you for supporting our efforts as we continue this secure, paperless process through Arbiter Sports/FamilyID. We have utilized this system since 2020 and have found it extremely beneficial in: gathering information about your child, identifying their specific needs, the collection of documents, our electronic communication to parents and not to mention the ease of athletic clearance process with our School Physician.
You should only have one FamilyID account. The information that is entered when you register your child carries over to each season. If you have already created a FamilyID account in the past - please do not create another account - this will delay the processes in clearing your child for athletics - not to mention the confusion.
You will be notified through FamilyID 30 days prior to expiration of the physical. The date tracker is always available to you to review. We ask that you upload additional documents and not override the previously submitted documents.
If something changes with your child's history, you can update within this one FamilyID account.
If you are experiencing difficulties or forget your password - please contact
Please refer to the Athletic website for specific sport information
The PPE MEDICAL ELIGIBILITY FORM will need to be electronically upload into your child's Arbiter Sports/FamilyID account, reviewed by our School Nurses and approved by our School Physician prior to athletic clearance.
Any paperwork submitted late or incomplete may be subject to delay in participation.
Physicals are valid for one year of exam date.
Parental permission is valid
(completely filled out, signed and dated)
within 90 days of the beginning of each athletic season.
What does this mean?
Please electronically submit PPE MEDICAL ELIGIBILITY FORM through Arbiter Sports / Family ID
Please bring to our attention any changes in your child's health, including injuries.
If your child is an incoming freshman OR transferring into
Pascack Hills -
A current physical / PREPARTICIPATION PHYSICAL EVALUATION MEDICAL ELIGIBILITY FORM must be completed by your child's Pediatrician and the PPE MEDICAL ELIGIBILITY FORM must be electronically submitted through Arbiter Sports/ Family ID
prior to Physical Education Participation.
If your child has specific Health Concerns:
Please inform me of any specific Health Concerns your child may have, as well as any modifications that are required while your child is in school.
Feel free to contact me should you need to schedule a meeting in order to discuss:
As it pertains:
* Please submit Food Allergy & Anaphylaxis Emergency Care Plan
* Asthma Action Plan
* Diabetes Medical Management Plan
*Seizure Action Plan
* Please submit any medical documentation for any other health concerns.
If your child has Life Threatening Allergies requiring the use of Epinephrine (EpiPen or Auvi-Q) as treatment for anaphylactic reaction:
*Please provide medical documentation regarding specific allergies
*Let me know if your child will carry their EpiPen or Auvi-Q and/or
if it will be stored in the nurse’s office
* Please submit Food Allergy & Anaphylaxis Emergency Care Plan
If your child requires prescription and/or Over-the-Counter Medication while in school:
* All medication must be in its original prescription and/or over-the-counter bottle
– no exceptions.
* All medication will be secured in the nurse’s office and as indicated, administered by the nurse.
* Please submit the Medication Administration Form
Thank you in advance.
Rose T. Welyczko, MA, BSN, RN, Certified School Nurse