FAQ's - NYS Required Health Examination Form

  • Updated Information to Support Families and Health Care Providers (9/9/21) 

    The Required New York State (NYS) School Health Examination Form is required pursuant to Commissioner Regulations 136.3(c)(1)(a).

    Considering the challenges families and schools were facing due to the COVID-19 pandemic, schools were encouraged to use the 2020-2021 school year to educate parents/guardians and healthcare providers regarding the new Required Health Examination Form to assist with the transition.

    For the 2021-2022 school year
    All student health examinations need to be documented on the NYS Required Health Examination Form or an electronic health record (EHR) compatible form. An unacceptable form will need to be redone by the School Medical Director.
    *Please note the school year begins on July 1st

    Background Information 

    1. What regulation mandates a required NYS School Health Examination Form?  
    Commissioner's Regulations CR 136.3 - School Health Services to be Provided 
    (c) Health certificates and proof of immunization
        1. Health Certificates
          (i) The health certificate shall:
              (a) be on a form prescribed by the commissioner and signed by a duly licensed physician, physician assistant, or nurse practitioner

    2. Why is a specific NYS school health exam form required for school physical exams?
    Pursuant to Commissioner’s Regulations only the Required NYS School Health Examination Form or an electronic health record equivalent form can be accepted by schools for student physicals conducted on or after July 1st, 2021. Some private healthcare exam forms did not contain the components required in state laws. Additionally, healthcare providers indicated it was difficult to complete the myriad of forms being required by individual school districts.  Schools indicated it was time-consuming for staff to review the various forms provided to the school that was inconsistent in terms of content and meeting the requirements of law. With this regulation, there are now only 2 forms in the state for school exams: The NYC form required for students attending NYC schools, and the NYS form required for students attending public schools outside of NYC.

    3. May a school (outside of NYC) accept a health exam that is not on the Required New York State School Health Examination Form?
    No, only the NYS Required Health Examination Form can be accepted by schools outside of NYC for student physicals conducted on or after July 1st, 2021. (Note NYC schools may only accept the NYC Health Examination Form)

    4. May a school accept a health exam that is not on the Required New York State School Health Examination Form from a bordering state?
    No, only the NYS Required Health Examination Form can be accepted for student physicals conducted on or after July 1st, 2021. 

    5. Are nonpublic/private schools required to use a specific form?
    No, Nonpublic/private schools outside of NYC are not required to use a specific form or require a health examination.

    6. May a school accept an electronic health exam form from a private healthcare provider? 
    Yes, if the form is on an Electronic Health Record Compatible Form.
    Instructions for Completion of the New York State School Health Examination EHR Compatible Form
    The above link provides direction to healthcare providers on the required components and the required presentation order of those components for an electronic health record form to be an equivalent form (NYSED, 2020). 

    7. May a provider use an electronic signature to sign the health certificate? 
    Yes, Electronic signatures may be accepted by a district. Districts should inform parents/guardians of whether they will accept a private office or clinic form, an electronic form, or an electronic signature. Any time a school has a question regarding the authenticity of a health certificate, they should verify the validity of the submitted certificate with the provider.

    8. May students be excluded from school for not providing the Required NYS School Health Examination Form?
    No, Parents/guardians should be informed that if their child's health exam was not completed on the correct form then their child will be required to have the health examination repeated at school by the school district’s medical director.

    Completing the Approved Form

    9. May schools modify the content of the Required NYS School Health Examination Form?
    No. The new NYS Required School Health Examination Form is a PDF and may not be modified.

    10. Is there a "fillable" PDF version of the Required NYS School Health Examination Form that a healthcare provider may upload and complete?
    Yes, the PDF is available as a fillable form.  Click any of the boxes to display an “x” or enter text in a text field as appropriate. The link to the "fillable" PDF version of the NYS Required School Health Examination Form is here.

    11. The Health Examination form currently available in the Health Commerce System has not been updated to the Required NYS School Health Examination Form. Can we accept it?
    Yes, the HCS will be uploading the Required Form soon. If a school receives an exam documented on the HCS form they may accept it for this school year but should provide a copy of the NYS Required School Health Examination Form to providers to educate them about the requirement.

    12. Who should healthcare providers contact about adding the Required NYS School Health Examination Form to their Electronic Health Records (EHR) System?
    Healthcare providers should contact their EHR vendor for assistance.

    13. May a healthcare provider create a form on their EHR that will be accepted as an equivalent to the NYS Required Health Examination Form?
    Yes, the Education Department and Department of Health worked with healthcare provider organizations to develop the Instructions for Completion of the New York State School Health Examination EHR Compatible Form, which indicates what must be included in an EHR form to meet the requirements.  Although the EHR equivalent may not look like the required form, it must contain the same information as required in state laws and the information is to be presented in the same order. 

    14. May a healthcare provider’s office staff electronically sign the EHR equivalent exam form?
    No, the exam form must be signed by the healthcare provider conducting the examination.  Electronic or written signatures from other office personnel including nurses are not acceptable even if they indicate they are signing for the healthcare provider.

    15. May a healthcare provider staple a completed health exam form (which is not an EHR equivalent) to a blank NYS School Health Examination form to make the exam acceptable?
    No, the healthcare provider must complete and sign the required form or an EHR equivalent form.

    16. May the school transcribe the contents from the healthcare provider’s form onto the NYS Required School Health Examination Form?
    No, such practice is considered to be altering a form and is illegal.  The healthcare provider must complete and sign the required form or an EHR equivalent form.

    17. Is a separate health exam form needed for participation in interscholastic athletics?
    No, the NYS Required School Health Examination Form will be used for New Entrants and students in grades Pre-K or K, 1, 3, 5, 7, 9, & 11, annually for interscholastic athletics (sports), working papers as needed, and for the Committee on Special Education (CSE) or Committee on Pre-School Special Education (CPSE).

    18. May the healthcare provider charge for copies of records if not done at the time of the physical?
    It may be dependent upon the participation status of the healthcare provider with that health insurer and whether their healthcare provider agreement addresses the issue. A complaint may be filed online at New York State Department of Financial Services Consumer Assistance Unit One Commerce Plaza Albany, NY  12257 800-342-3736 (Consumers Hotline) 518-474-6600 (Outside of NYS) 518-474-2188.

    19. What may parents/guardians do if the healthcare provider refuses to use NYS Required School Health Examination Form?
    Parents/Guardians may contact their healthcare insurance company.  Parents/Guardians may also choose to find another healthcare provider.

    Helping Parents/Guardians and Healthcare Providers Comply with This Requirement

    20. How can schools inform parents/guardians?
    Schools should notify parents/guardians of the upcoming changes via their schools’ website, newsletters, back to school events, PTA/PTO. We recommend posting this information on the school website, asking teachers to share this information via their classroom newsletter/updates, and sending paper copies when possible to ensure equitable access for all parents/guardians of the above resources. When sending paper copies please include a copy of the Required Health Examination Form for parents/guardians. We also encourage schools to ask parents/guardians to share this information with local healthcare providers in their area.

    21. How can parents/guardians help their healthcare provider ensure they have the Required NYS School Health Examination Form?
    Parents/Guardians should bring the approved form with them to their child’s medical appointment, so it can be completed at the time of the visit. Some offices charge an additional fee for completing forms after the visit as this may be considered an additional service.

    22. What resources are available to inform parents/guardians, healthcare providers, and administrators? 
    To assist schools in notifying and informing parents/guardians and local healthcare providers, we have created the following sample resources. These resources should be reviewed by the school medical director and administration. The sample resources can be modified as needed to align with local school district needs prior to use. The resources include:

    23. Who is responsible to notify healthcare providers of the Required NYS School Health Examination Form?
    The form was disseminated to healthcare providers through healthcare professional organizations and the NYSDOH shared the form with School-Based Health Centers. However, it is important that school districts and parent groups all collaborate in sharing this information to minimize difficulties for students.

    Schools can maintain a log of medical practices that are not using the required form and reach out to them with a copy of the information provided above. We recommend a reminder letter be sent to both medical practices and families in early June to assure that exams performed over the summer are completed using the required form.

Last Modified on September 9, 2021