Sports Physical Information
Attention Parents/Guardians:
**Please refer to the Sports Physical Checklist located toward the bottom of this page for more information in regard to requirements for the packet and to ensure all necessary information is submitted to the nurse**
Medical Eligibility Form: This is the ONLY form that is submitted to the school nurse, in addition to the three Sign-off Sheets. Please ensure the Physician both signs and Stamps this form, includes the date of exam, includes the status of clearance for participation, AND signs that the have completed the Cardiac Professional Development Module.
Sign-Off Sheets: There are THREE sign-off sheets that should be signed and returned to the school nurse, with the Medical Eligibility Form.
*Sudden Cardiac Death
*Opioid Use/Misuse
*Concussion
Health History Update Questionnaire: Each season (Fall, Winter, Spring) a HHUQ will be required to be completed ONLINE for participation in any sport. This form will be send to your email via school messenger a few weeks prior to the beginning of sports. The form will also become available on the school Home Page at this time.
The HHUQ online form also acts as a sign-up for the sport. Please ensure this form is completed in its entirety. Your child will NOT be signed up for the sport until this form is completed.
*FORMS WILL BE RETURNED IF THERE IS ANY MISSING INFORMATION AND CLEARANCE FOR PARTICIPATION WILL BE DELAYED* Please submit by the deadline. If you're unsure if your child wants to participate in sports, it is better to complete one and submit it just in case, rather than waiting until the last minute.
Submit a paper copy only! No email copies will be accepted!
Attention Students:
It is your responsibility to check with the health office to determine if your physical is valid. Sports physicals are valid for 365 days from the date of exam, and must fall within 365 days of the first day of sports beginning.
If you wear glasses or contacts, please remember to bring them with you to your physical examination.
REMINDER: The Scholastic Student-Athlete Safety Act (N.J.S.A. 18A:40-41.7) mandates that sports physicals may only be completed by a licensed physician, advanced practice nurse or physician’s assistant who 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 conducting a student’s sports physical.

The sports programs are provided by the Howell Township Police Athletic League.
Southard School
115 Kent Road
P.O. Box 713
Howell, NJ 07731
Phone: 732-919-2825
School sports are offered during the fall, winter and spring seasons.
- Fall sports include: Boys’ Soccer, Girls’ Soccer, Girls’ Field Hockey, and Cross Country
- Winter sports include: Boys’ Basketball, Girls’ Basketball, Wrestling, and Cheerleading
- Spring sports include: Boys’ Baseball, Girls’ Softball, and Track and Field
Late submission of Sports Physical Forms may result in delay or ineligibility to participate.
The student’s parent must also complete the district Medical Update forms for participation prior to each sport season in which the student wishes to participate. These forms will be sent out through school messenger two weeks prior to each season.
If you have any questions regarding forms for sports or eligibility dates, please contact your school nurse prior to deadline dates.