To allow RN to communication with Students provider regarding health concerns. 

NYSED requires a physical exam for new entrants and students in Grades Pre-K or K, 1, 3, 5, 7, 9 & 11; annually for 
interscholastic sports; and working papers as needed; or as required by the Committee on Special Education (CSE) or 
Committee on Pre-School Special education (CPSE).

For new students entering the district, including Prek, Kindergarten-  This is NOT for sports. 

This form may be used as an addendum to a medication order which does not contain the required diagnosis and attestation for a student to independently carry and use their medication as required by NYS law.