New state forms for health and dental examinations

September 2023

Dear Parents and Guardians:

All New York State public school students must have a health exam when they enter school as a new entrant and in Pre-K or Kindergarten and grades 1, 3, 5, 7, 9, and 11. These examinations must be completed on the approved NYSED Student Health Examination Form (2023) for School.

  • Click here for the 2023 health/physical examination form.

The examination must be completed by a New York State licensed physician, physician assistant or nurse practitioner and on the approved NYSED Student Health Examination Form for School.

In 2023-2024 ONLY the approved form will be accepted.

A dental certificate stating that your child has been seen by a dentist or dental hygienist is also asked for at the same time.  The school will provide you with a list of dentists and registered dental hygienists who offer dental services on a free or reduced cost basis if you ask for it. Click here for the dental health certificate.

Please take note:

  • A copy of the health examination must be provided to the school within 30 days from when your child first starts at the school, and when your child starts K , 1st , 3rd, 5th, 7th, 9th, & 11th grades. If a copy is not given to the school within 30 days, the school will contact you.
  • If your child has an appointment for an exam during this school year that is after the first 30 days of school, please notify the Health Office with the date.
  • Communication between you and school health staff is important for safe and effective care at school. Your healthcare provider may not share health information with school health staff without your signed permission. Please talk to your provider about signing their consent form for the school at the time of your child’s appointment for the examination.

Sincerely,
Susan M. Swartz
Superintendent of Schools