Maryland Record of Student Physical Exam

Students entering a Maryland public school for the first time need a physical examination recorded on the form designated by the State Department of Education and the Department of Health. Parents complete the health history, and the examining physician or nurse practitioner completes the school health assessment so the school nurse knows about diagnoses, emergency needs, medications and activity limits.

Who completes it

The parent or guardian completes Part I, the health assessment history, and signs it. A physician or nurse practitioner completes Part II, the school health assessment, or attaches a copy of the child's physical examination instead.

Submitting and payment

How to submit it
The completed form is returned to the parent, who gives it to the school. The exam must be done within nine months before entering the public school system or within six months after entering.
Who pays
The form sets no fee and does not address who pays for the examination.

Good to know

  • Part II asks whether the child has a condition that may require emergency action at school and, if so, asks the provider to work with the school nurse on an emergency plan.
  • Findings are marked within normal limits or abnormal by body system, alongside health areas of concern such as attention deficit, development, hearing, learning problems, lead exposure and nutrition.
  • Screenings recorded with dates include tuberculin test, blood pressure, height, weight, BMI percentile and hearing, with lead testing marked optional on this form.
  • Immunizations go on the separate Maryland immunization certificate (896) or a computer-generated record, and the school must retain this form until the student is age 21.

Get the official form

Download the current version from the source each time; forms change without notice.

Record of Student Physical Exam

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

When must the Maryland school entry physical be done?

The instructions to parents say a physical examination by a physician or certified nurse practitioner must be completed within nine months before entering the Maryland public school system or within six months after entering. It applies to students entering a Maryland public school for the first time.

Can a provider attach their own exam instead of completing Part II?

Yes. The form says Part II must be completed by a physician or nurse practitioner, or a copy of the child's physical examination must be attached. Part I, the parent's health history, still needs to be completed and signed.

Does the Maryland student physical form cover school medications?

Part II asks whether the child is on medication and for the medication and diagnosis, but a separate medication administration form must be completed for each medication given in school.