NYS School Health Exam Form (Updated 2021)

Please submit a physical exam each year for new enrollment and for grades PK, K, 1, 3, 5, 7, 9, and 11.

A doctor's office form with the same elements and format (Physical Exam, Height/ Weight/ BMI, Allergies and Chronic Conditions, Problem List, Screenings, and Recommendation for Participation) that is signed or electronically signed by the healthcare provider (MD, DO, NP or PA) is also accepted. 

NYS Health Exam Form 2021_HCSD.pdf, 357.98 KB; (Last Modified on February 11, 2021)