Physicals will be held in the High School Health Office at 8:30 AM (by appointment only) on the following dates for school year 2019-20
ALL FORMS MUST BE HANDED INTO THE NURSE'S OFFICE 2 WEEKS BEFORE DATE
Dates are subject to change 2019-20
October 3rd, 17th, 31st
January 2nd, 30th
February 6th, 20th
March 5th, 12th
May 7th, 28th
Medical examinations are required prior to participation on a intramural athletic team or squad. The examination shall be conducted by your health care provider within 365 days of the start of the sport activity. The NJ Dept. of Education Annual Pre-Participation Physical Exam Form Part A and Part B must be used. Your child can obtain the form from our health office or you can download the form from our webpage under health forms. The school doctor will be available by appointment to do physicals for students who do not have a health care provider.
Sports Form Directions
1. Prior to participation on a school-sponsored interscholastic or intramural athletic team or squad for students enrolled in any grades six to 12;
i. The examination shall be conducted within 365 days prior to the first day of official practice in an athletic season and shall be conducted by a licensed physician, advanced practice nurse (APN), or physician assistant (PA).
ii. The physical examination shall be documented using the Preparticipation Physical Evaluation (PPE) form developed jointly by the American Academy of Family Physicians, American Academy of Pediatrics, 15 American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine and available at, http://www.state.nj.us/education/students/safety/health/records/athleticphysicalsform.pdf, in accordance with N.J.S.A. 18A:40-41.7.
(1) Prior to performing a preparticipation physical examination, the licensed physician, APN, or PA who performs the student-athlete's physical examination shall complete the Student-Athlete Cardiac Screening professional development module and shall sign the certification statement on the PPE form attesting to the completion, pursuant to N.J.S.A. 18A:40-41d.
(A) If the PPE form is submitted without the signed certification statement and the school district has confirmed that the licensed physician, APN, or PA from the medical home did not complete the module, the student-athlete's parent may obtain a physical examination from a physician who can certify completion of the module or request that the school physician provides the examination.
(2) The medical report shall indicate if a student is allowed or not allowed to participate in the required sports categories and shall be completed and signed by the original examining physician, APN, or PA.
(3) An incomplete form shall be returned to the student's medical home for completion unless the school nurse can provide documentation to the school physician that the missing information 16 is available from screenings completed by the school nurse or physician within the prior 365 days.
iii. Each student whose medical examination was completed more than 90 days prior to the first day of official practice in an athletic season shall provide a health history update questionnaire completed and signed by the student's parent or guardian. The completed health history update questionnaire shall include information as required by N.J.S.A. 18A:40-41.7.b.
The school doctor must review and approve all physical forms prior to your child's participation in a sport activity.
Sandshore Elementary School
498 Sandshore Rd
Budd Lake, NJ 07828
Mountain View Elementary School
118 Cloverhill Drive
Flanders, NJ 07836
Chester M. Stephens Elementary School
99 Sunset Drive
Budd Lake, NJ 07828
Mt. Olive Middle School
160 Wolfe Road
Budd Lake, NJ 07828