Q: What is the timeframe for a health exam to be considered valid to participate in athletics?
A: The health examination for qualifying a student's participation in athletics is valid for a period of 12 continuous months, through the last day of the month in which the exam was conducted and through the entire sports season, even if the exam’s expiration is before the season is completed.

Q: Is a separate health exam needed for participation in interscholastic athletics?
A: No separate health exam is required. A valid New York State (NYS) Required School Health Examination Form signed by a duly licensed physician, PA, or NP who is authorized to practice in NYS can be used.

Q: Who completes the health examination?
It is at the discretion of the medical director to accept a private healthcare provider’s health examination or to perform the examination of the student.

A: Ideally, the student’s private healthcare provider (a physician, nurse practitioner, or physician assistant) should perform the health examination. The private provider has knowledge of the student’s family, home, previous illnesses, health history, immunization status, and other background factors to assist in evaluating the total health status of the student. They are also able to order additional tests and institute any necessary therapeutic measures.

*The district’s medical director, who is a physician or NP, is required to perform a health appraisal on students who have not provided the school with a copy of the health examination conducted by a private healthcare provider. (Education Law § 904).

Page Updated 4/16/25

Q: Who approves participation in interscholastic athletics?
A: All students must have the approval of the school medical director prior to participating in interscholastic athletics. The school medical director has the responsibility to determine the physical capability of a student to participate in interscholastic athletics in consultation with the student’s primary medical provider and other specialists, the parents/guardians, the student, and the coaching staff.

Q: What components are needed for a student to participate in athletics?
A: 

• • Required NYS School Health Examination Form - Completed by a New York State licensed private health care provider or school medical director. Required annually for the student wishing to participate in the school’s interscholastic athletic program. 
  • Sample Recommended NYSED Interval Health History for Athletics - Completed by parent/guardian within 30 days prior to the start of the sport. Required for the student wishing to participate in additional seasons of interscholastic athletics who has had a physical exam that school year. * unless a health exam has been completed within 30 days before the start of the season. See Dominic Murray FAQs for additional information.
  • Medical Certificate of Limitations - (For students with restrictions or modifications) Completed by the private health care provider. Provides information on the activity and level of activity in which the student may participate during physical education for students with medical limitations. 

Q: Can the school medical director delegate the review of physicals and re-certification forms to the school nurse?
A: Yes, a medical director may delegate the review of health certificates/interval health history forms for participation in athletics only to a school nurse (RN), NP, or PA. If this task is delegated, the medical director should provide concise written protocols for the school nurse to follow when accepting a private healthcare provider’s clearance and contact them with any questions or concerns.

Q: Can the school medical director delegate the review of Health Examination forms and Interval Health History forms to an LPN?
A: No, an LPN may not review health examinations or Interval Health History forms for participation in athletics. Assessment is outside the scope of practice of an LPN.

Q: Can the medical director delegate the review of health examinations and Interval Health History forms to the certified athletic trainer?
A: Certified athletic trainers cannot review the form as the form includes health information which exceeds their statutory scope of practice. The interval health history form will need to be reviewed by the medical director or an RN (if delegated) before participation in athletics.

Q: What is the procedure for clearing/ recertifying students for Interscholastic Sports? 
A: Prior to participation in each athletic season, all students must have a valid health examination/health appraisal and an Interval Health History form, NYS Interval Health History Form (nysed.gov) completed and signed by the parent/guardian- unless a health exam has been completed within 30 days before the start of the season. *See the Dominic Murray FAQs for compliance with the Dominic Murray Sudden Cardiac Death Prevention Act.

The medical director or designee (RN, NP, or PA) reviews the health certificates/interval health history forms for participation in athletics. Students with any recent injury/illness/or changes in their interval health history should be interviewed by the school medical director or their designee. If this task is delegated, the medical director should provide concise written protocols for the school nurse to follow when accepting a private healthcare provider’s clearance and contact them with any questions or concerns.

Q: What are the requirements of the Dominic Murray SCA Act to participate in athletic activity?
A: See the Dominic Murray FAQs.

Q: What should the Athletic Director provide the school nurse?
A: The athletic director should provide a list of all student-athlete candidates to school health personnel before each sports season begins to verify that all athletes have been cleared to participate and have completed all health requirements for participation. After tryouts are completed, the final team roster should be given to school health personnel as a double-check that the health requirements are met. Athletic and health services staff should work cooperatively to ensure eligible athletes are facilitated to participate and ineligible athletes are not allowed to participate until all clearances are finalized.

Q: Can an 18-year-old sign the Interim Athletic Health Form themselves if they are 18?
A: No. An 18-year-old who is still a dependent and in high school will need a parent/guardian's signature. Schools act in loco parentis and therefore must have parent/guardian consent.

Q: Can students participate in activities conducted prior to being cleared for athletic participation?
A: No, a student must be cleared prior to participating in athletics. The student may attend practices as long as they are not participating.

Q: Is urinalysis required for a student's participation in interscholastic sports?
A: State laws and regulations do not require urine testing for students to participate in sports. Please check with your athletic governing body (e.g., NYSPHAA) regarding urine testing for a specific sport such as wrestling. Urine testing is typically done prior to matches, since a urine test done months earlier would not reflect the student’s current status.

Page Updated 4/28/25

Mixed Competition
For clarification of the New York State Education Department Commissioner’s Regulations for Physical Education and Athletics regarding Mixed Competition, please contact the Office of Curriculum and Instruction at (518) 474-5922. For inquiries specific to competition governance, you may wish to contact your local athletic governing body. For inquiries specific to competition governance, you may wish to contact the New York State Public High School Athletic Association (NYSPHSAA) at (518) 690-0771 and/or toll-free at (866) 598-2816.

Page Updated 4/16/25

Q: What is the procedure for requesting permission for special devices and prostheses for athletic participation?
A: The New York State Public High School Athletic Association (NYSPHSAA) has a procedural guideline, Permission for Special Accommodations, which details the process that a school district should follow for students who have special devices, such as insulin pumps or sensors, to participate in interscholastic sports. The guidelines state that the District Athletic Director (AD) must request approval of any special devices from the NYSPHAA Assistant Director responsible for safety, who will provide written notice of approval or denial to the school district. Once NYSPHSAA has approved the accommodation for a student, it remains in effect for the entire time the student plays interscholastic sports. This notice is kept by the AD. A copy should be given to the student’s coach, who is responsible for showing it to the referee upon request.

Page Updated 4/16/25

Q: What is the Athletic Placement Process?
A: Athletic Placement Process (APP) NYSED is a program for evaluating students who want to participate in sports at higher or lower levels. Commissioner’s Regulation Section 135.4(c)(7)(ii)(a)(4).

Q: Are Tanner Scores required to play up in a sport?
A: Tanner scores are no longer required numbers but are now recommended numbers for the APP.

Q: What is the process for a student to play up according to the APP?
A: Information for districts is found in the Athletic Placement Process for Interschool Athletic Programs (NYSED 12/2017)

Page Updated 4/16/25