Dear Parents of Athletes,
You have been invited to participate in an optional new program for completing your annual sports physical evaluation form electronically online.
Date of Physicals: Feb 3, 2016
Location: Ridge High School (Athletic Training Room/Main Gym)
Schedule will be as following: NO NEED TO CALL FOR APPOINTMENT. WALK IN BASIS.
MUST PRE- REGISTER AT www.gotomysportsphysical.com
February 3rd, 2016
All Spring sports from 12:30-2:30
In lieu of printing out paper forms and bringing them to your personal physician,
you can now fill them out online and electronically send them
to our school physician - Dr.Silberman, who will perform your physical exam at the school.
Simply, log on to https://www.gotomysportsphysical.com
*If you are a minor (less than 18 years of age) your parent/guardian must be present with you at the time of filling in your forms online, as the athlete and parent must sign the forms.
Follow all instructions on the site. If you have NOT been to the site before, then read the instructions at
https://www.gotomysportsphysical.com/households/getting-started to register. Please store your password in a safe place. If you forget it, you can reset it via http://www.gotomysportsphysical.com/households/password/new
Once you are registered, use the “Fill Forms” wizard to select the school and sport. Make sure you select Ridge High School, Basking Ridge, NJ. Be sure to read the packet instructions to choose the packet that is correct for your purpose.
While filling out your health history, you will be asked to fill in information about the physician details:
689 Valley Road, Suite 104
Gillette, NJ 07933
After submitting the health history, you will need to release the form to Dr. Silberman. Click on “ Release Health History” and enter Dr. Silberman’s National Provider Identifier (NPI): 1215964846. . **If you enter the NPI incorrectly, your form will not go to Dr. Silberman. When you hit submit, your form will automatically be sent securely to Dr. Silberman.
** You still need the actual physical exam to be performed at the school. Payment of $40.00 per physical will be collected prior to the physical exam. Please make checks payable to the order of Dr. Marc Silberman.
Any Questions or concerns please email:
Scott Hoagland email@example.com
Aimee Mitchell Aimeemitchell@bernardsboe.com