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Sports Physical Info "R" School Registration


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 New Jersey Department of Education (NJDOE) is pleased to announce the availability of
the Student-Athlete Cardiac Assessment professional development module (PD module) required
by the Scholastic Student-Athlete Safety Act (SS-ASA) (N.J.S.A. 18A:40-41.7). The PD module can
be found at

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);

• Upon performing a physical examination, the physician, APN or PA shall sign the certification
statement on page four of the Pre-Participation Physical Evaluation (PPE) form attesting to the
completion of the PD module. The physical exam packet can be viewed at
(N.J.S.A. 18A:40-41d);

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.

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