New School Health Examination Form Required for 2021-2022 School Year

As a result of changes to Section 136.3 of the Regulations of the Commissioner of Education, for any student physicals conducted on or after January 31, 2021, the student health certificate must now “be on a form prescribed by the commissioner.” This means that, beginning with the 2021-2022 school year, school districts may only accept the State Education Department-approved health examination form for students. The official “Required NYS School Health Examination Form” is available for download at: http://www.p12.nysed.gov/sss/documents/health-exam-form.pdf.

The State Education Department developed the Required NYS School Health Examination Form for several reasons. Some private healthcare exam forms did not contain the components required in state law, and it was time-consuming for school district staff to review the various forms from different healthcare providers. It was also challenging for healthcare providers to complete the multiple different forms being required by individual school districts.

The Required NYS School Health Examination Form has already been disseminated to healthcare providers via healthcare professional organizations. However, the NYS Center for School Health suggests that school districts maintain a log of local medical practices who are not using the required form, and reach out to these practices with a copy of the new form and instructions for use.

In order to ease this transition for health care providers, schools, and parents, SED and the New York State Department of Health have made the Form available in multiple formats. The form may be printed by a parent and brought to the student’s physical to be completed by their provider. The Form is also available as a fillable PDF. Finally, SED and DOH have worked to develop instructions for healthcare providers on how to prepare an electronic health record-compatible version of the Required NYS School Health Examination Form, which may be signed and submitted electronically.

Many families will have student physicals performed during the summer months in preparation for fall athletics and the start of the new school year. Therefore, if you have not already notified parents, we recommend communicating this change as soon as possible via the school district website, newsletters, and email. A Sample Parent/Guardian Notification is available at: https://www.schoolhealthny.com/cms/lib/NY01832015/Centricity/Domain/85/HealthExam_FormResources3.3.21.docx. A paper copy of the form can also be included in back to school and/or registration packets. While students may not be excluded from school if their parent does not submit the Required NYS School Health Examination Form, school districts should inform parents that their child will be required to have the health examination repeated at school by the school district’s medical director if the Form is not submitted.

Please note that, in light of the COVID-19 pandemic, SED previously extended the timeframe within which students must provide proof of a health examination for the 2020-2021 school year; parents unable to obtain a health examination for their child in the required grade (Pre-K/Kindergarten, 1, 3, 5, 7, 9, and 11) have until September 1, 2021 to provide the Required Form to the school district. SED encourages school districts to communicate to parents that the school district’s medical director will complete a health examination at the beginning of the 2021-2022 school year for those students who were required to have an examination to attend school during the 2020-2021 school year but who have not yet provided a health examination certificate for the 2020-2021 school year by September 1, 2021.