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Physical Examination and Health Information Forms

Health Examination Forms

Saint Peter's Prep requires an updated immunization record and an annual physical of all students.  The physical must be performed by an M.D., D.O. or nurse practitioner by the dates indicated in the letter sent by the Principal in June.  

All questions about health records should be directed to the school nurse, Ms. Maureen Sheppard, R.N., at or 201-547-6406.  Athetes should contact the athletic trainer, Mr. Joseph Lisella, at or 201-547-2306.

The required immunization and health examination forms, as well as any optional forms, may be accessed below.


Required of ALL students (click below to download)

Physical Examination Form

Immunization Record

Pamphlet "Sudden Cardiac Arrest in Young Athletes"

Parent Sign-off Sheet on "Sudden Cardiac Death"


Optional Forms (click below to download)

Request for Medication to be Administered by the School Nurse Form

Request for Self-Administration of Medication Form

Asthma Treatment Plan Form

Diabetic Medical Management Plan Form

Authorization for Glucagon Administration by Non-School Nurse Personnel form

Severe Allergic Reaction Form (Epi-pen)


Required Student-Athlete Forms (click to download)

Every student athlete must have the following forms completed and on file for each sport they participate in. All items are contained in the single PDF linked above.

  1. Parent Permission Form
  2. Parent Transportation Release Form
  3. NJSIAA Concussion Consent Form
  4. NJSIAA Steroid Policy Consent Form