City School District of New Rochelle's Athletics Program requires students to be medically cleared by their School Health Office prior to tryouts or participation in any sport.

Complete and return the following forms to you child's School Nurse:

Name of Form

All Students

Specific Students

Health Examination Form


Completed by your own Healthcare Provider or School Healthcare Provider

Interval Athletic Health History


Completed and signed by your Parent/Guardian

Head Injury/Concussion Information Sheet (English/Spanish)


Read and signed by Student Athlete and Parent/Guardian

Medication Administration Form


Student requires medication during school, practice or events.

Medication Attestation Form for Independent Use


Student requires medication AND can self-carry and self-administer medication.

To best ensure the health and safety of your student athlete during each athletic season, please alert the Health Office immediately, if your child:

  1. Sustained an injury requiring medical treatment

  2. Is hospitalized

  3. Requires surgery

  4. Is diagnosed with a serious illness

  5. Missed school for greater than 5 days

For information regarding the Health Services requirements, please call: 

NRHS Health Office: 914-576-4575

ALMS Health Office: 914-576-4331

IEYMS Health Office: 914-576-4368

For information regarding the Athletics Program, please call:

Athletic Department: 914-576-4586