Embedded Files
Is your athlete cleared to play?
Please contact Medical Director, Chelsea Kolb FNP-C, if you are need of the following:
Sports Physical
NYSPHSAA Permission for Special Accommodations: The NYS Public High School Athletic Association (NYSPHSAA) Permission for Special Accommodations form can be used to request permission for special devices such as insulin pumps or sensors, prosthesis, religious accommodations, and unique accommodations in sports participation.
Concussion clearance following Return-to-Play
Clearance to play sport after physician evaluation for increased risk for sudden cardiac arrest
Wrestling Skin Check
Sports Forms
Dominic Murray Sudden Cardiac Arrest Prevention Act
On July 1, 2022, The Dominic Murray Sudden Cardiac Arrest Prevention Act was written into New York State law to ensure that schools, students, and parents/guardians are provided with critical, lifesaving information on sudden cardiac arrest (SCA) risks. Prior to participation in interscholastic athletics, we require students and parents to review the signs, symptoms and health histories that may increase the risk of SCA. This document is available for review on our Final Forms website, and a signature is required from both the student and parent/guardian prior to participation in sports. A complete copy of the law is available for review here.
"any student displaying signs or symptoms of pending or increased risk of sudden cardiac arrest shall be immediately removed from athletic activities, and shall not resume athletic activity until he or she has been evaluated by and received written and signed authorization from a licensed physician; and retain the authorization on file in the student’s permanent health record." - NYSED
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