Freehold Regional High School District

Charting a Future of Excellence in Education

Athletic Physical Forms

Sports  
 
Pre-participation Physical Evaluation Information
All athletes are required to submit paperwork each season. Paperwork deadlines:
Fall Athletes: August 1
Winter Athletes: October 21
Spring Athletes: February 17
 
 
Please review the date of last physical on the summary screen on the Parent Portal or check with the Nurse's Office.  

The following forms must be completed online in the Genesis Parent Portal. These forms can be accessed in the “Forms” tab:

  1. Activity/ Athletic Eligibility Form (Must be completed each season for students participating in multiple sports)
  2. Health History Update Questionnaire (Must be completed each season for students participating in multiple sports) – Please explain all “yes” answers thoroughly. 
  3. Athletic Emergency Card Information (Must be completed once each academic year)
  4. Sports Related Concussion and Head Injury Fact Sheet (Must be completed once each academic year)
  5. The Sudden Cardiac Death in Young Athletes Information Sheet (Must be completed once each academic year)
  6. NJSIAA Steroid Testing Policy (Must be completed once each academic year)
 
If a VALID physical is on file in the health office, you do not need to submit any additional forms. Please review the date of your last physical on the Student Summary screen in the Parent Portal to determine if it is valid.


If a valid physical is NOT on file in the health office:

The Pre-Participation Physical Evaluation Packet is required. (ALL 4 PAGES)
  1. History Form 
  2. Athlete with Special Needs Supplemental Form 
  3. Physical Evaluation Form 
  4. Clearance Form

The packet can be found here and should be printed: http://www.state.nj.us/education/students/safety/health/records/athleticphysicalsform.pdf

Attention Parents/Guardians
Please make sure the physician writes the actual date of the physical exam and it is the same date on the History Form, Physical Evaluation Form and the Clearance Form. The Physical Evaluation Form and the Clearance Form must be signed by the physician and must be complete, including height, weight, vision, pulse, and blood pressure. All abnormal findings must be explained. Your physician must complete and sign off on the Cardiac Assessment Professional Development Module. The History Form must be signed by the parent and student. *Please explain all “yes” answers; include dates, length of symptoms and treatment.

Attention Students
It is your responsibility to check with the health office to determine if your physical is valid. If you wear glasses or contacts, please remember to bring them with you to your physical examination.
 
REMINDER: The Scholastic Student-Athlete Safety Act (N.J.S.A. 18A:40-41.7) mandates that sports physicals may only be completed by a licensed physician, advanced practice nurse or physician’s assistant who 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 conducting a student’s sports physical.
 
If you are not able to complete the forms on the Parent Portal – please request paper copies of all forms from the school Supervisor of Extracurricular Activities (SECA). 
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