School Nurse:  Ms. Stephanie Rodriguez

As a reminder, all incoming 6th graders who have reached the age of 11 years will need a current TDAP and MENINGOCOCCAL immunization by the first day of school.  For any questions, please feel free to call or email: Email Ms. Stephanie Rodriguez or telephone: 732 650-5290 Ext. 32010.

Public Schools of Edison Township

Sports Physicals
Scholastic Student-Athlete Safety Act
Information Fact Sheet
For Parents / Guardians

Prior to participation on a school-sponsored interscholastic or intramural athletic team or squad, each student-athlete in grades 6-12 must present a completed pre-participation physical evaluation (PPE) form/Physical Form #14a to the designated school staff member (Coach in the high school or School Nurse in the middle school).  Important information regarding the PPE Form #14a is provided below, and you should feel free to share with your child's medical home health care provider.

• The Form #14A may ONLY be completed by a licensed physician, advanced practice nurse (APN) or physician assistant (PA) that 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 scheduling an appointment for a physical. 

• The required Form #14A must be conducted within 365 days prior to the first official practice in an athletic season.  Form #14A is available on the district  website, scroll over to Departments then Health Services and on the left scroll over to form and you will find Form #14A.

• The parent/guardian must complete the History Form (page one).  The parent/guardian must complete The Athlete with Special Needs:  Supplemental History Form (page two), if applicable, for a student with a disability that limits major life activities and insert the date of the required physical examination on the top of the page.

• The licensed physician, APN or PA who performs the physical examination must complete the remaining two pages of Form #14A and insert the date of the examination on the Physical Examination Form (page 3) and Clearance Form (page four).

• The school district must provide written notification to the parent/guardian, signed by the school physician, indicating approval of the student's participation in a school-sponsored interscholastic or intramural athletic team or squad based upon review of the medical report or must provide the reason(s) for the disapproval of the student's participation.

• For student-athletes that had a medical examination completed more than 90 days prior to the first official practice in an athletic season, the Health History Update Questionnaire must be completed and signed by the student's parent/guardian.  The Form #14G must be reviewed by the school nurse, and if applicable, the school's athletic trainer.  The Form #14G is available on the Edison website.

Public Schools of Edison Township
Sports Physicals

For more information, please review the Frequently Asked Questions

You may also direct questions to the Coach, School Nurse or Athletic Director.