Physical Exam Form & Dental Health Certificate

Education Law requires all New York State (NYS) public school students to have a health exam when they are a new student in a school district and when they enter Pre-K or Kindergarten, and grades 1, 3, 5, 7, 9, and 11.  

Beginning on 2/1/21, schools cannot accept the health exam if it is not on the required form or the required health record equivalent. 

Required New York State School Health Examination Form:  

It is the fundamental policy of the Board of Education to have medical examinations of pupils attending public schools made by the family's private physician whenever possible.  This policy recognizes the fact that the family physician is the most familiar with the health problems of the pupil and best able to institute treatment when needed.

If the examination form is not submitted to the School Nurse, the School Physician (Medical Director) will do a health appraisal on all new entrants, in Pre-K or Kindergarten, and in grades 1, 3, 5, 7, 9, and 11. 

A Dental Health Certificate is requested for all newly entering students, and for students in Pre-K or Kindergarten, and grades 1, 3, 5, 7, 9, and 11.   


Download the Physical Exam Form and Dental Health Certificate (to be completed by a medical provider):