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Annual Physical

A current physical exam is required at the start of each and every school year.  This is the only form that will be accepted. Please remember to bring this form to the physician’s office at the time of your daughter’s physical. Do not forget to make a copy for your own records.

 


Physicals are done on or after June 1, and submitted on the first day of school to the homeroom teacher. Please do not mail the form as the school is closed during the summer. Fax copies CANNOT be accepted ( NJ State Law ). 

  • The first page is the history form that must be completed, signed, and dated by the parent/guardian. Incomplete forms will not be accepted. The second page, IF APPLICABLE, is for the parent/guardian to complete and both the parent/guardian and student to sign and date.
  • The last two pages are for the examining physician to complete, sign, date with the date that the physical was done, and stamp. The fourth page must be signed and dated in two fields. The first signature is for clearance to participate, with the date of physical.  The second signature is for the completion date of the NJ Cardiac Assessment Module was completed.
  • Physicals must be done by a US licensed physician (NJ State Law).

Original Completed Physical Forms must be returned on the first day of school in September, with a current copy of the Immunization Record. Clearance for sports, physical education classes, school trips, and any school-sponsored activities will not be issued without the entire form. Please keep a copy for your own records. NO EXCEPTIONS.

 

Health Office Forms

Asthma/Reactive Airway/Respiratory Problem

Any student diagnosed with Asthma/Reactive Airway/Respiratory Problem that requires the administration of prescription medication for control of this condition must submit this form. NJ State Law. Asthma Action Form Students are required to carry their medication with them at all times.

 

Allergies Requiring Emergency Medications

 

Any student diagnosed with an allergy that requires Emergency Medication (Epi-Pen/Epi-Pen Jr./Auvi-Q) must submit: Emergency Health Care Plan with Authorization to Administer Epinephrine and Acknowledgement of School Policy: Health Care Plan and Epinephrine Students are required to carry this medication with them at all times.

Medication to be Administered During the School Day

Any medication that will be administered during the school day must be accompanied by the Medical Authorization Form. Page 1 of this form is a two part consent. Parent completes the first part, and physician completes the second part. Full directions are on page 2. Medical Authorization Form.pdf

Download, print, complete, and submit forms on the first day of school.