Medina Central School District

New York State mandates physicals for all students entering grades PK or K,1,3,5,7,9 and 11, and new students entering the school district in any grade. Physical forms are also needed for sports and work permits. This examination may be completed by the child’s own physician or by the school doctor. Students who do not provide proof of a physical examination by a personal physician will be examined by the school doctor at the beginning of the school year. These forms are valid for one calendar year. 

• Please provide a note from your child’s doctor if your child has an illness or injury that would restrict them from participating in PE classes/sports. A physician must then write another note to remove any restrictions. 
• Please provide a note from your child’s healthcare provider if your child has had surgery (including oral) or a procedure. This note should provide specific details about restrictions or that the student does not have any restrictions.
• Physical Education teachers and coaches will be notified as appropriate.

NYS School Health Examination form 5/2024