Athletics Forms

OLDER VERSION (Paper Copy):

The following Sports Pre-Participation Physical Packet MUST be completed in whole EACH school year to participate in a sport. Physicals MUST be conducted by a healthcare provider who: 1) is a licensed physician, advanced practitioner nurse, or physician's assistant; and 2) completed the Student-Athlete Cardiac Assessment Professional Development Module.

*** Please note: If a student-athlete has a previous physical examination on file within the last 365 days, the following forms MUST be completed EACH sports season:

ATTENTION (New procedure as of November 2023):

Please read thoroughly and follow the steps below. In order for a student-athlete to participate in High School or Middle School Sports, they must be fully cleared. There are TWO sets of student-athlete forms that must be submitted.

Step 1: Verify student-athlete contact information

Log into your RealTime Parent Portal with your username and password.

Please remember to update all relevant information for accuracy under the "Contacts" section. If changes are required, click on "Update Information" on the bottom right hand corner.

Step 2: Submit a New Physical OR Health History Update Questionnaire

The following forms must be submitted via HARD COPY format once online forms are submitted.

  1. NEW PHYSICAL - Student-athletes will need to submit a paper copy of the Health History and Physical Evaluation forms. Click HERE. All 4 pages of your pre-participation physical evaluation forms MUST all be signed by the student-athlete, parent/guardian, and physician.

    1. Valid for 365 days.

    2. Must be conducted by a healthcare provider who: 1) is a licensed physician, advanced practitioner nurse, or physician's assistant; and 2) completed the Student-Athlete Cardiac Assessment Professional Development Module.

  2. For student-athletes with a current physical, please submit the Parental Consent and Health History Update Questionnaire forms. Click HERE. Forms MUST be signed by the student-athlete and parent/guardian.

    1. Physical date was within 365 days of FIRST official day of practice.

    2. Must be completed every athletic season when student-athlete's physical examination form is passed 60 days of being completed.

 

If submitting a new physical, please continue on to Step 3.

Step 3: Submit the electronic forms online (Complete ONCE per school year)

  1. Under the Menu column to the left, click on the “Sign Ups” tab.

  2. Click on the "Sign Up" tab for the sport.

  3. Click on the "View Document" of EACH form to acknowledge you have completed each document. Please take the time to thoroughly read and complete all sections. You must click View Document for EACH form to acknowledge that you have reviewed.

Form  instruction photo

Please submit forms to the athletic trainer, nurse, or coach. If you are having trouble getting an appointment with your pediatrician, please contact Ms. Monika or your school nurse and we will discuss your options. 

Student-athletes will be restricted from sports participation (practices, games, and scrimmages) until ALL forms are on file or returned to the athletic trainer or nurse. Any changes in an athlete's medical history or ability to participate in physical activity MUST be reported to the athletic trainer or nurse immediately.

If you have any questions about physical forms, please feel free to contact Ms. Monika, the athletic trainer, via Email Ms Monica

Frequently Asked Questions regarding physicals and the pre-participation packet for Bogota High School and Bogota Middle School Student-Athletes.

Where can I find and download the pre-participation packet?

All forms can be found ABOVE on the Bogota Athletics website. Click on the Sports Pre-Participation Packet. If you are unable to print, please contact your coach, Ms. Monika, or go to the Nurse's Office for a packet.

Who can complete my physical form?

A physician, advanced practice nurse (APN), physician assistant (PA). The physical can be performed by your own health care practitioner or performed at a walk in clinic (ex-CVS minute clinic).  

How long is my physical valid for?

A physical is valid for 1 year from the date of issuance. The physical expires 1 year from the date listed on the form signed by the doctor.  A physical issued 9/1/19 is good until 8/31/20.

What do I do if my physical expires during my season of play?

If your physical is not expired on the first day of practice, you are eligible to participate for that season.  You will need an updated physical for the next season of play. Example: If a season begins on 8/12 and your physical expires 9/1, you are eligible to participate for that Fall season.  You would be ineligible to participate in winter season without an updated physical. 

My physical expires before or on the first day of practice. Can I practice?

If practice starts on 8/12 and your physical expired 7/15, you are ineligible to practice without a new physical. If your practice starts on 8/12 and your physical expires on 8/12, you are ineligible to practice that day or until your new physical is filed with the nurse.

What is a health history update form and what do I need it for?

A health history update form is to be turned in for each sport season that you participate.  

Can a note from my doctor saying my son/daughter is cleared for practice be used in lieu of the physical forms?

No. All physicals must be completed on the forms provided from our website. 

The following questions are copied from "Scholastic Student-Athlete Safety Act (P.L. 2013, c. 71) Frequently Asked Questions and Answers found at Scholastic

1. What if my child does not have a medical home or primary health care provider?

Students with health insurance should have a medical home. If you do not have a medical home or health insurance notify the school nurse. The district board of education shall make accessible information regarding the NJ Family Care program to students who are knowingly without medical coverage pursuant to N.J.S.A.18A:40-34.

If a student does not have a medical home, the school district shall provide the examination at the school physician’s office or other comparably equipped facility, pursuant to N.J.S.A.18A:40-4.

2. What PPE Form is required?

The PPE Form was updated jointly by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine in 2019 and again in 2023 and adopted for use by the New Jersey Department of Education in 2024. The NJDOE notified districts regarding the updated form in a NJDOE broadcast memo.

3. What pages of the PPE do I need to submit to the school?

The medical eligibility form is the only document that should be submitted to the school. The health history questionnaire and physical exam form should be maintained by the healthcare provider completing the physical exam.

4. Can the PPE Form be modified?

No. Pursuant to N.J.S.A.18A:40-41.7 2(a) The board of education of a public school district and the governing board or chief school administrator of a nonpublic school shall require that prior to the participation of any student enrolled in grades six to 12 on a school-sponsored interscholastic or intramural athletic team or squad, the student shall have a physical examination using the "Preparticipation Physical Evaluation" Form developed jointly by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. The PPE Form shall include the history and physical examination components. The PPE Form shall also include a certification statement, to be signed by the licensed physician, advanced practice nurse, or physician assistant who performed the physical examination, attesting to the completion of the current professional development module developed pursuant to subsection a. of section 3 of P.L.2013, c.71 (C.18A:40-41d).

The updated form no longer requires the submission of the health history questionnaire or the physical exam portion of the exam to the school.

5. Is there a place on the PPE Form for the physician’s stamp?

Yes. The PPE Form developed pursuant to the law does not require a physician’s stamp. However, the “clearance page” of the PPE Form has been revised to include an area for the HCP’s office stamp. The HCP performing the exam must still sign the certification for clearance and the statement attesting to the completion of the cardiac assessment module developed by the NJDOE.

6. How should LEA’s satisfy requirements set forth at N.J.A.C.6A:16-2.2(h)1.iv., which requires written notification be signed by the school physician stating approval of the student's participation be provided to parents?

As the Department is unable to further modify the PPE without amendments to the statute governing the use of the PPE, LEAs are required to develop a process and procedure for satisfying this requirement. Procedures could include developing a form letter on district letterhead disseminated to the parents. It is permissible to use an electronic signature to satisfy this requirement.

7. Does the school nurse and the school physician need to review the history and physical exam section?

No. The school physician is only required to review the medical eligibility form. This is an administrative signature verifying the healthcare provider medically cleared the student for participation and the attestation statement to the completion of the cardiac assessment module is signed. In accordance with N.J.A.C. 6A:16-2.2(h)1. iv. and N.J.A.C. 16-2.3(a)4. iv, the school physician must provide written signed notification to the parent or guardian stating approval or disapproval (and the reason for disapproval) of the student’s participation in athletics based upon the medical report.

8. Where should the medical eligibility form be kept?

The medical eligibility form should be kept in the student’s health file at school and recorded on the A-45 pursuant to N.J.A.C. 6A:16-2.4. A health record of each pupil shall be kept, in which shall be entered the findings of each examination, and such record shall be the property of the board of education and shall be forwarded to any public school to which the pupil is transferred, if such school is known (N.J.S.A. 18A:40-4).

9. Can an e-mail serve as written notification stating the school physician reviewed and approved the PPE Form?

No. N.J.A.C. 6A:16-2.2(h)1. iv and N.J.A.C. 6A:16-2.3(a)4iv require the LEA to “provide to the parent written notification signed by the school physician stating approval of the student’s participation in athletics based upon the medical report or the reasons for the school physician’s disapproval of the student’s participation.” An email notifying a parent of their student’s approval or disapproval to participate in athletics alone does not meet these requirements. However, email may be used to transmit written notification to parents of students indicating the school physician’s approval or disapproval of their participation in athletics. Once the form is signed electronically or stamped, then it may be forwarded to the parent.

10. Can forms be sent electronically?

School districts that have purchased or use a system where PPE forms are sent electronically to the school physician for review and approval are advised that the medical eligibility form may contain confidential health information and should be handled in compliance with the same confidentiality as other student education and health records. For additional information and guidance, you may wish to visit the US Department of Education’s page on protecting student privacy.

11. Is it necessary to complete and approve the required medical eligibility form before the first day of practice or tryouts?

Yes. The physical exam must be completed within 365 days of the first practice. It must be submitted, reviewed, and approved by the school physician before the student can participate. Students whose physical exam is up to date on the first day of the season (tryouts) are cleared for the entire season regardless of whether the physical exam form expires mid-season.

Parents/guardians may want to consider scheduling the exam and submitting the medical clearance before tryouts to allow time for completion of the review and approval process. Districts may set timelines and deadlines for submission to align with scheduled tryouts.

12. Does the term “physician” only mean MDs and DOs or are other individuals such as chiropractors allowed to complete physicals?

According to N.J.S.A.18A:40-1, “physician” refers to physicians licensed to practice medicine and surgery within the state. N.J.S.A.18A:40-41.7 allows licensed physicians, advanced practice nurses and physician assistants to conduct the student-athletes` pre participation physical exam. This has not changed. Since chiropractors are not licensed to practice medicine or surgery, nor are they specifically named in the law, they are not allowed to complete the physical.

13. Can a district have one general sign-off sheet for all required signatures (i.e., Sudden Cardiac Death Pamphlet, Steroid Testing Policy Consent, Sports-related Concussion and Head Injury Fact Sheet)?

No. N.J.S.A.18A:40-41 requires districts to distribute the following documents to each student-athlete and the student’s parent or guardian each year and prior to participation by the student in an athletic activity.

  • Sudden Cardiac Death in Young Athletes Brochure N.J.S.A.18A:40-41.9

  • Opioid Use and Misuse Educational Fact Sheet N.J.S.A.18A:40-41.10

  • Sports Related Concussion and Head Injury Fact Sheet N.J.S.18A:.40-41.2

These documents, whether physically distributed or electronically disseminated, must be individually signed, and submitted. One generic signature for all documents is not acceptable. The forms are available on the NJDOE website for student athletes.  

14. What is the supplemental history form of the PPE for students with special needs?

The “Athletes with Special Needs: Supplementary History Form” of the PPE is for students who have physical disabilities due to birth injuries, genetic malformation, accidental injuries, trauma, or other causes. An athlete must first be determined to have a disability under the ADA before this form is used. This form is to be completed by the student's parent or guardian before taking the student to the HCP for the medical examination. The form is kept on file by the HCP completing the physical examination.

15. When is the Health History Update Questionnaire required?

In accordance with N.J.S.A. 18A:40-41.7 if a student’s PPE was completed more than 90 days prior to the first day of official practice in an athletic season, a health history update questionnaire is required.

16. Will additional clearances be needed if a parent denotes “yes” to one of the questions on the Health History Update Questionnaire?

The certified school nurse and athletic trainer (if applicable) are required to review the Health History Update Questionnaire. The form includes only what the law requires. However, it is the responsibility of the certified school nurse and the LEA, pursuant to N.J.S.A. 18A:40-4, to pursue appropriate follow-up for “yes” answers to determine whether medical attention is necessary and therefore, whether to delay clearance to participate in the athletic season to ensure that the student is healthy and fit to participate.

17. Does an 18-year-old student need a parent to complete the history form of the PPE Form?

Yes. Unless the student is legally emancipated, the PPE Form includes questions regarding the student and family history and the law requires the parent or guardian to complete the form and sign at the bottom of the page. This form should be completed and submitted to the HCP performing the physical examination.

18. Does the school nurse have to sign the “Health History Update Questionnaire” also known as the 90-day update indicating that he/she reviewed the form?

No. There is no requirement for the certified school nurse to sign the form. However, it is the responsibility of the certified school nurse to pursue appropriate follow-up for “yes” answers to determine whether medical attention is necessary and therefore, whether to delay clearance to participate in the athletic season to ensure that the student is healthy and fit to participate.

19. Does the HCP completing the PPE Form need to provide documentation of completing the Cardiac Assessment Training module?

No. The HCP performing the exam is only required to sign the certification statement on the PPE Form attesting to completion of the professional development module.

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