Florida now requires an EKG before a first-time high school athlete can take part in tryouts, practice or competition. The requirement comes from the Second Chance Act, which took effect July 1, 2026, and it is documented on the FHSAA EL1 form. It applies to every incoming 9th grader for the 2026-27 school year and to any student in grades 10 through 12 who has not played a high school FHSAA sport before. Returning high school athletes are exempt. TrufaMED performs the physical and the EKG in the same visit in Surfside, and the interpretation is signed by Dr. Shane D. Naidoo.
Parents have been getting this rule secondhand, and the version circulating locally is usually wrong in one of two ways. Some families think every athlete needs an EKG every year. Others think a season of middle school sport exempts a 9th grader. Neither is right. Here is what the form actually says.
Who needs the EKG for 2026-27
The statute language on the EL1 covers all first-time high school participants in FHSAA athletics. In practice that means two groups:
- Every incoming 9th grader planning to try out for an FHSAA sport in 2026-27.
- Any student in grades 10, 11 or 12 who has not previously participated in a high school FHSAA sport. A transfer student who played club or travel ball but never a high school season falls here.
The point families miss most often: playing an FHSAA middle school sport does not exempt a 9th grader. The word in the statute is “high school.” A student who played middle school volleyball in 8th grade is still a first-time high school participant in 9th, and still needs the EKG documented.
Returning high school athletes are exempt. If your child played a high school FHSAA sport last year, the EKG is not required again. FHSAA encourages it anyway, and plenty of families choose to do it, but it is not a condition of participation for a returning athlete.
The EKG is not annual. It runs on a two-year rolling window
This is the part that saves families money and gets misreported most often. The EL1 accepts an ECG completed within two years prior to July 1 of the participation year. For the 2026-27 year, that means any ECG done on or after July 1, 2024 satisfies the requirement.
So if your child had an ECG at a cardiology visit in 2025, bring that record. A parent may attest on the form that a prior ECG was completed. You do not need to repeat it.
The window rolls forward each year, so do not memorize the July 1, 2024 date. Check it against the participation year on the form you are handed.
Which FHSAA forms you actually need
| Form | What it is | Who completes it |
|---|---|---|
| EL1 | Cardiovascular assessment, including the ECG documentation the new law requires | Parent completes the history. A licensed practitioner completes and signs Section B. |
| EL2 | The preparticipation physical evaluation itself. Valid 365 calendar days. | Examining practitioner |
| EL3 | Consent and release to participate, carrying new statute language this year | Parent and student |
Two housekeeping changes worth knowing. FHSAA removed page 5 from the EL2 this year, and the EL3 was rewritten to match the new statute, so parents must use the current version of the EL3. A copy saved from last season will be rejected. Download the current forms from FHSAA rather than reusing a PDF from a team group chat.
What happens if the tracing is abnormal
Participation stops until a physician provides written clearance. That is the rule, and it is the entire reason the law exists.
An abnormal tracing on a screening ECG is not a diagnosis. It means the reading falls outside the expected pattern for a young athlete and needs a closer look, often an echocardiogram or a cardiology referral. Many turn out to be normal athletic adaptations. Some do not, and that second category is what the Second Chance Act was written to catch before a first practice rather than after a collapse on a field.
Build in time for this. An EKG done in mid-August leaves room to sort out a question before the season. An EKG done the night before tryouts does not.
Medical exception and religious objection
The EL1 provides two paths that do not involve completing the ECG. A family may file a Medical Exception on the ME1 form, or a Religious Objection. Both are documented on the form itself. The requirement also applies to students who have no cardiac symptoms, which is the point of a screening program: symptoms are usually absent right up until they are not.
Who is allowed to sign the EKG interpretation
Section B of the EL1 accepts a signature from a practitioner licensed under Florida Chapters 458, 459, 460, 464.012 or 464.0123, who is familiar with the International Criteria for ECG interpretation in student-athletes. That is a wider list than most parents expect.
At TrufaMED, Dr. Shane D. Naidoo signs the EL1 interpretation. He is board-certified in emergency medicine and reads these tracings against the athlete criteria rather than the general adult criteria, which matters, because a trained heart looks abnormal by general standards and normal by athlete standards.
Students who are not playing a sport
School entry health requirements are a separate lane and no EKG is involved. Florida asks for the DH 3040 school entry physical for kindergarten, 7th grade and students new to Florida, plus the DH 680 immunization certificate. We handle both at our school physicals visit.
Getting it done at TrufaMED
The physical, the EKG and the paperwork happen in one visit at 9445 Harding Ave in Surfside. Self-pay is $200 with the EKG included through October 1, 2026. There is no separate EKG charge on that visit, and the EL2 and EL3 go home with you the same day.
Most urgent care clinics and retail minute clinics price a sports physical between $45 and $76, and cannot perform an EKG at all, which means a second appointment somewhere else. We have on-site EKG, X-ray, lab and ultrasound, so a question raised during the exam gets answered during the exam.
Booking details are on our sports physicals page, or call (305) 537-6396 and the front desk will book the visit and tell you which forms to bring.
Frequently asked questions
Does every high school athlete in Florida need an EKG now?
No. The requirement applies to first-time high school participants in FHSAA athletics: every incoming 9th grader for 2026-27, and any student in grades 10 through 12 who has not played a high school FHSAA sport before. Returning high school athletes are exempt from the requirement, though FHSAA encourages the screening for everyone.
My child played a middle school sport. Are they exempt?
No. The statute says first-time high school participants. Middle school participation, including FHSAA middle school sport, does not exempt an incoming 9th grader. This is the single most common misunderstanding we hear at the front desk.
How often does the EKG have to be repeated?
It is not an annual test. The EL1 accepts an ECG completed within two years prior to July 1 of the participation year. For 2026-27 that means an ECG done on or after July 1, 2024 satisfies the requirement, including one performed elsewhere.
When did the Florida EKG requirement take effect?
Florida’s Second Chance Act took effect July 1, 2026. The ECG must be documented on the FHSAA EL1 form before a first-time high school participant takes part in tryouts, practice or competition.
What does a sports physical with the EKG cost in Miami?
At TrufaMED the self-pay price is $200 with the EKG included through October 1, 2026. That is a single charge covering the preparticipation physical, the EKG and the form completion. Most retail clinics charge $45 to $76 for the physical alone and do not have an EKG on site.
Who is allowed to sign the EKG portion of the EL1?
Any practitioner licensed under Florida Chapters 458, 459, 460, 464.012 or 464.0123 who is familiar with the International Criteria for ECG interpretation in student-athletes. At TrufaMED, Dr. Shane D. Naidoo signs the interpretation.
What if the EKG comes back abnormal?
Participation stops until a physician provides written clearance. An abnormal screening tracing usually leads to further evaluation such as an echocardiogram or a cardiology referral. Many findings turn out to be normal athletic adaptation. Schedule the physical with enough time before tryouts to work through a question if one comes up.
Can I use last year’s EL3 form?
No. The EL3 was rewritten this year to carry new statute language and parents must use the current version. FHSAA also removed page 5 from the EL2. Download the current forms rather than reusing a saved copy.
Does a student who is not playing sports need an EKG for school?
No. School entry uses the Florida DH 3040 physical for kindergarten, 7th grade and students new to Florida, along with the DH 680 immunization certificate. There is no EKG requirement for school entry.
Can we get the physical and the EKG on the same day?
Yes. The physical, EKG and forms are done in one visit at our Surfside clinic. Walk-ins are welcome seven days a week, and booking ahead in August is worth doing because that is when the volume arrives.