1. Student will be provided a Medical Information Form by a physical education teacher, school counselor, or the school health aide. (see file to the right ------>)

2. The teacher, counselor, or health aide will explain to the student and/or parent/guardian that physical education is a required course (a graduation requirement in high school) and that it is necessary that the form be returned, completed by a licensed physician, listing limitations/modifications and activities in which the student can and cannot participate.

3. The form must be completed by the student’s medical doctor. The form must be signed by both the doctor and the parent/guardian and returned within one week from the time the student received the form.

4. If a Medical Information Form is returned indicating “no physical activity,” the school–site health aide/clerk should contact the district nurse assigned to the school. The nurse will then communicate with the student’s physician to review the form and explain the California State requirements for physical education course credit. The nurse should then determine, with the input from the student’s doctor, if acceptable modifications can be made; if so, the nurse will send another Medical Information Form for the doctor to complete, listing recommended modifications.

5. When the form is returned with specific limitations/modifications listed, copies of the form should be forwarded to the physical education teacher, the counselor, and the school health aide.

6. The physical education instructor, when possible, will modify the physical education activities to meet the health requirements of the student and satisfy the California State Content Standards.

7. Students that have a Medical Information Form returned a second time indicating “no physical activity” face the following alternatives:

Students with a recommendation of “no physical activity” for 6 weeks or LESS:

The students will be required to make-up the incomplete physical activity/assessments once they have been released from their doctor recommended restriction. Any missed physical activity/assessment will be recorded as “0”/incomplete until it is made up/completed.

Students with a recommendation of “no physical activity” for MORE than 6 weeks:

Once a student has accumulated 6 or more weeks of “no physical activity,” the student will be dropped from the physical education class and added as a “Teacher Assistant” in the same class period, with the same teacher. The student will then receive ELECTIVE credit for that semester. He or she will NOT receive PE credit for that semester. This student will be considered in the overall class count, with the class maximum remaining at 52 students per class.

Students with a recommendation of “no physical activity” for an indefinite period of time:

A student whose doctor has indicated an ongoing “no physical education” status or a student with a severe medical condition for which adequate modifications cannot be made to accommodate the student and satisfy curriculum requirements should be directed to Instructional Services in order to apply for a temporary exemption.

“The governing board of a school district or the office of the county superintendant of schools of a county may grant temporary exemption to a pupil from courses in physical education if the pupil is ill or injured and a modified program to meet the needs of the pupil cannot be provided.”