The health care provider that does your sports physical must complete the Student-Athlete
Cardiac Assessment Professional Development Module, or the school cannot accept the
physical exam. Please share this information with your health care provider, and make sure
that the provider signs the certification statement on page four of the physical exam packet.
If this is not signed, the physical cannot be accepted, and will be returned to the student.
TO: Health Care Providers Performing Student Sports Physicals
SUBJECT: Student-Athlete Cardiac Assessment Professional Development Module
The SS-ASA requires that:
• The PD module be completed by the physician, advanced practice nurse (APN), or physician
assistant (PA) who performs a student-athlete’s annual physical examination prior to the
student’s participation on a school-sponsored interscholastic or intramural athletic team or squad
in grades six through 12 (N.J.S.A. 18A:40-41.7);
During the summer, please bring your completed physicals to UHS Main Office, so they can be
processed immediately. Do not send them to Kawameeh Middle School because the School
Nurse will not get them until school starts again in September.