New Jersey law (N.J.S.A. 18A:40-41.7) requires a preparticipation physical before a public-school student joins a school sport, and the Department of Education's 2024 form is the version NJSIAA posts. The five-page packet adds a PHQ-4 mental health screen to the PPE history, and only the Medical Eligibility Form is submitted to the school.
The student and parent complete and sign the history form before the appointment. A licensed physician, advanced practice nurse or physician assistant who has completed the NJDOE Student-Athlete Cardiac Assessment Professional Development module performs the exam and signs the eligibility form, certifying that training.
Download the current version from the source each time; forms change without notice.
Preparticipation Physical Evaluation (New Jersey PPE Form)
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A licensed physician, advanced practice nurse or physician assistant who has completed the Student-Athlete Cardiac Assessment Professional Development module hosted by the New Jersey Department of Education. The provider signs a certification of that training on the Medical Eligibility Form, next to an optional office stamp.
Yes. NJSIAA posts a Spanish version of the 2024 NJDOE preparticipation physical evaluation form alongside the English one, and the Health History Update Form and sudden cardiac death pamphlet sign-off are also offered in both languages.
Only the Medical Eligibility Form, which records the eligibility decision, recommendations, the provider's signature and cardiac module certification, and shared health information such as allergies, medications and emergency contacts. The history and exam pages are kept by the medical home and are not shared with schools.