Scholastic Student Athlete Safety Act - Information for Parents/Guardians
participation on a school-sponsored interscholastic or intramural athletic team
or squad, each student-athlete in grades six through 12 must present a
completed Preparticipation Physical Evaluation (PPE) form to the designated
school staff member. Important
information regarding the PPE is provided below, and you should feel free to
share with your child’s medical home health care provider.
For more information,
please review the Frequently Asked Questions which are available at http://www.state.nj.us/education/students/safety/health/services/athlete/faq.pdf.
Additionally you can contact the school nurse with questions.
- The PPE may ONLY be completed by a
licensed physician, advanced practice nurse (APN) or physician assistant (PA)
that has completed the Student-Athlete Cardiac Assessment professional
development module. It is recommended that you verify that your medical provider has
completed this module before scheduling an appointment for a PPE in order to not delay clearance for your child to play sports.
required PPE must be conducted within 365 days prior to the first official
practice in an athletic season. The PPE
form is available along with additonal required forms on the school’s website.
parent/guardian must complete the History Form (page one), and insert the date
of the required physical examination at the top of the page.
parent/guardian must complete The Athlete with Special Needs: Supplemental
History Form (page two), if applicable, for a student with a disability that
limits major life activities, and insert the date of the required physical
examination on the top of the page.
licensed physician, APN or PA who performs the physical examination must
complete the remaining two pages of the PPE, and insert the date
of the examination on the Physical Examination Form (page three) and Clearance Form
licensed physician, APN or PA must also sign the certification statement on the
PPE form attesting to the completion of the professional development
module. Each board of education and
charter school or nonpublic school governing authority must retain the original
signed certification on the PPE form to attest to the qualification of the
licensed physician, APN or PA to perform the PPE.
school district must provide written notification to the parent/guardian,
signed by the school physician, indicating approval of the student’s
participation in a school-sponsored interscholastic or intramural athletic team
or squad based upon review of the medical report, or must provide the reason(s)
for the disapproval of the student’s participation.
- For student-athletes that had a
medical examination completed more than 90 days prior to the first official
practice in an athletic season, the Health History Update Questionnaire (HHQ)
form must be completed, and signed by the student’s parent/guardian. The HHQ must be reviewed by the school nurse
and, if applicable, the school’s doctor or athletic trainer.