Preparticipation Physical Evaluation (PPE)

Preparticipation Physical Evaluation (PPE)

*SEE SUBMISSION DATES BELOW - PARENT EMAIL

School policy and NJ State regulations require the following:
Go Knights The Preparticipation Physical Evaluation (PPE) 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 PPE.

  • The required PPE must be conducted within 365 days prior to the first day of tryouts or practice in an athletic season. If the physical becomes invalid during the season a new physical must be completed in a reasonable amount of time. For this purpose, a reasonable amount of time will be considered 2 weeks. The PPE form is available at PPE Athletic Physicals Form

  • The parent/guardian must complete the History Form (page one), and insert the date of the required physical examination at the top of the page.

  • 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 the PPE, and insert the date of the examination on the Physical Examination Form (page three) and Clearance Form (page four).
    Forms will not be accepted with blanks. Please have the medical provider fill out the form completely.

  • The licensed physician , APN or PA must also sign the certification statement on the PPE form attesting to the completion of the professional development module. Each board of education and charter school or nonpublic school governing authority must retain the original signed certification on the PPE form to attest to the qualification of the licensed physician, APN or PA to perform the PPE.

  • If student's participation is NOT approved, the school district will provide a written notification to the parent/guardian, signed by the school physician of the disapproval reason(s).
  • For students who already have an up to date physical, please read the following to see if it applies to you:

    Student athletes that have had a physical more than 90 days prior to the first day of tryouts or practice: Must have the Health History Update Questionnaire (HHQ) form completed, and signed by the student's parent/guardian. The HHQ must be reviewed by the school nurse. The HHQ is available at Health History Update (HHQ)

    Example of email to parents:

    Dear Parents, 

    Please save the dates below, and if you have any questions regarding CDW Athletics, contact Sabatino Lauriello.

    Fall Sport: Submit between June 18, 2018, and August 31, 2018

    Winter Sport: Submit before November 2, 2018

    Spring Sport: Submit before February 14, 2019


    *Please submit all forms to the school nurse.

    Additional Information:
    A licensed physician may ONLY complete the Preparticipation Physical Evaluation (PPE), 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 PPE.

    https://cdw.oldtappanschools.org/for_students/athletics/

    Form:
    https://cdw.oldtappanschools.org/UserFiles/Servers/Server_350239/File/Athletics/Preparticipation%20Physical%20Evaluation%20(PPE)/athleticphysicalsform.pdf

    Please read and confirm when completing the Parent Portal.
    https://cdw.oldtappanschools.org/departments/nurse/sudden_cardiac_death_-_pamphlet


    Please read and confirm when completing the Parent Portal.
    https://cdw.oldtappanschools.org/departments/nurse/concussion_management_guidelines




    Thank you, 

    Sabatino Lauriello
    CDW Student Manager
    Summer Enrichment Program 
    201-664-1475 - 2102
    https://cdw.oldtappanschools.org/departments/student_manager


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