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The University of the State of New York THE STATE EDUCATION DEPARTMENT Office of the Professions Division of Professional Licensing Services www.op.nysed.gov Physical Therapy Form 1 Department Use
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How to fill out form 1 nysed physical?

01
Obtain the form: You can either download the form from the New York State Education Department (NYSED) website or obtain a physical copy from your school or healthcare provider.
02
Fill in the student's information: Provide the student's full name, date of birth, gender, address, and contact information.
03
Medical history: Answer questions regarding the student's medical history, including any existing medical conditions, allergies, medications, surgeries, or hospitalizations.
04
Immunization record: Provide a detailed record of the student's immunizations, including the vaccine types and dates administered. Ensure that the immunizations are up to date as per NYSED guidelines.
05
Physical examination: Schedule an appointment with a licensed healthcare provider for a physical examination of the student. The healthcare provider must fill out the required sections, which include assessment of general health, height, weight, vital signs, vision, hearing, blood pressure, and recommendations for any further testing or follow-up.
06
Parent/guardian acknowledgment: The parent or legal guardian must sign and date the form, acknowledging the accuracy and completeness of the information provided.
07
Submitting the form: Once the form is completed, submit it to the appropriate school or educational institution as instructed.

Who needs form 1 nysed physical?

01
Students in New York State schools: All students attending school in New York State are required to have a completed form 1 nysed physical on file with their educational institution.
02
Student-athletes: Individuals participating in school sports or athletic activities must undergo a physical examination and submit form 1 nysed physical to ensure they are physically fit to participate.
03
Students transferring from out-of-state: Students transferring from another state or country into a New York State school system must provide the completed form to meet the health requirements of the state.
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Form 1 NYSED Physical is a health form required by the New York State Education Department that documents a student's physical health status to ensure they are fit for school participation.
Students entering school for the first time, as well as those in certain grades and sports programs, are required to file Form 1 NYSED Physical.
To fill out Form 1 NYSED Physical, complete the sections regarding personal information, health history, immunizations, and physical examination results. It should be signed by a licensed healthcare provider.
The purpose of Form 1 NYSED Physical is to ensure that students are medically fit to participate in educational and extracurricular activities, thereby promoting health and safety within schools.
The form requires reporting the student’s personal details, medical history, results of the physical examination, immunization records, and any health restrictions or recommendations.
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