Physical Forms and Health History Forms » Physical Packet and Health History Forms

Physical Packet and Health History Forms



ALL forms must be filled out in PEN!


Parent/Guardian and Student must complete and sign Consent Form For Interscholastic Athletics.


Parent/Guardian must fill out and sign the New Jersey Interscholastic Athletic Association COVID 19 questionnaire.  


Parent/Guardian must complete and sign the history form.  Please answer all questions.  The student must sign the form as well.  


A physician must complete, sign, and stamp the physical examination form and the clearance form.  Please do not forget to document vision, blood pressure and pulse.


****Physician must sign that they have completed the Cardiac Assessment Professional Development Module.****  


If your child has asthma, your physician must provide you with an asthma treatment plan and permission to self administer paperwork.  


The Parent/Guardian and student must sign the concussion form, NJSIAA steroid testing policy, Sudden Cardiac Death Pamphlet, use and misuse of opioid drug fact sheet, and the opioid video sheet.


Any incomplete forms will be returned!


Take a picture of paperwork and email it to Mr. Wagner at [email protected] or [email protected]