ECG/EKG Screening Requirement for Student Athletes

Effective July 1, 2026, pursuant to Florida’s Second Chance Act, certain students must complete a one-time heart screening prior to participation in any FHSAA-sanctioned athletic activity, including tryouts, practices, and workouts. Students meeting the EL1 requirement that are participating in summer activities with the school will need a completed EL1 prior to continuing activities after July 1.

The requirement applies to:
• All incoming 9th grade student-athletes
• Students in grades 10–12 who have not previously participated in an FHSAA high school sport
Note: Students who have already participated in an FHSAA sport are not required to complete the screening; however, it is strongly recommended.
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No. Students who meet the screening requirement must complete and submit the FHSAA EL1 form verifying the heart screening (or approved exemption) prior to participation.

Heart screenings are designed to help identify undetected cardiac conditions that may increase the risk of sudden cardiac events during athletic participation. Early detection supports the health and safety of student-athletes.

Screenings may be completed through:
• School-sponsored events (on-site screenings)
• Approved organizations such as Who We Play For
• A licensed healthcare provider, clinic, or hospital
Students should consult their school athletic director or coach for available options

No. The heart screening (EL1) and the preparticipation physical evaluation (EL2) are separate requirements and may be completed in any order.

• Many providers offer screenings at no cost or reduced rates
• School-based screenings are capped at $50 in accordance with state guidelines

Contact your school’s athletic department to identify additional opportunities. Families may also:
• Utilize community screening events
• Schedule an appointment with a healthcare provider
• Visit www.whoweplayfor.org for upcoming screening dates

Yes. All student-athletes attending FHSAA member schools, including private schools, must comply with this requirement.

Completion of the FHSAA EL1 form is required to certify:
• Completion of the heart screening, or
• Documentation of an exemption/objection

• No, in most cases the parent/guardian completes and signs the EL1
• A physician signature is required in Section B if the screening is conducted by a private healthcare provider

Students entering 9th grade must complete the requirement; however, a screening performed on or after July 1, 2024 may satisfy the requirement, provided documentation is submitted.

Yes. An exemption may be selected for religious reasons only by the parent or guardian and must be properly documented on the EL1 form.

No. The heart screening is a one-time requirement during a student’s high school eligibility period.

Schools maintain compliance through Home Campus, the approved eligibility software for FHSAA schools, where the EL1 form will be required and monitored.

Parents/guardians should maintain copies of:
• Heart screening results
• Completed EL1 form
These documents must be provided to the receiving school for eligibility verification.

Screenings are administered by trained professionals, with results reviewed by a licensed physician.

A recommendation for additional testing does not necessarily indicate a medical condition, but rather the need for further evaluation. Families will be provided guidance on next steps.

Yes. The FHSAA provides supplemental forms, including:
• EL1/2S Form – for physician documentation and additional clearance following further evaluation
• ME1 Form – allows a physician to exempt a student from screening if under active medical care
These forms are available on the FHSAA website.

• Website: www.whoweplayfor.org
• Phone: 1-888-906-9973

All non-traditional students must submit the EL1 (if applicable), EL2, EL3, GA4, Official transcripts or grade records (home school/PEP). Additionally, home school students must submit the EL7 packet. PEP students must submit an EL15 along with proof of acceptance of the scholarship. All other non-traditional student types must submit the EL16 packet.

The school where you participate at first is the school you must participate at in all sports, unless that school does not offer a sport. In that case, you may participate in that specific sport at another school in the county you live in, without needing to meet any transfer regulations.

Since you have an opportunity to participate in the sport at the school you attend, you may not participate in that sport at an FHSAA member school.

Students may only participate outside of the county they live in when the county they live in does not offer the sport.

If no public or charter school offers the sport and the student/family cannot come to an agreement with a private school, the student may participate at a school in an adjacent county.

An adjacent county is a county that touches the border of the county a student lives in.

To appeal for participation outside of an adjacent county, the school you wish to participate at must complete an EL10.

According to state law and FHSAA bylaws, a student may only appeal when the county they live in and the adjacent counties do not offer the sport. If the county the student lives in offers the sport, the student must participate in their county.

No. Per FHSAA rules, a student with multiple residences will establish his/her residence at the first school he/she attends, or the first school he/she participates at (as a non-traditional student) on or after the first official start date of any sport’s season.

Yes. If you were a rostered student-athlete at a school outside of the county you live in during the 2025-26 school year, you may continue to participate at the school for the remainder of your eligibility. See the information below on grandfathering in.

• Non-traditional students who were rostered student-athletes in the 2025-26 school year at a school that is outside of the county they live in, may continue to participate at that school for the remainder of their eligibility. 
• Grandfathering in is specific to a school not a county.
• Grandfathering in does not apply to students who only participated at a school during the summer prior to the signing of Senate Bill 538. The student must have been rostered in the 2025-26 school year.
• If a non-traditional student was rostered at multiple schools during the 2025-26 school year, he/she may only be grandfathered in at one school.

EXAMPLE: Jill is home schooled and entered 9 grade in 2024-25. She lived in Pasco County but participated on the girls volleyball and softball teams at a 9-12th grade school in Hillsborough County for the 2025-26 school year. Given that Jill meets all other eligibility requirements, she will continue to be eligible at that school in Hillsborough County for the 2026-27 and 2027-28 school years.

Sudden cardiac arrest is the leading cause of death in student‑athletes. Many heart conditions show no symptoms but can be detected through a quick ECG. The law honors Chance Gainer, an 18‑year‑old Florida athlete who passed away in 2024 from an undiagnosed heart condition.

• All incoming 9th‑grade athletes
• Any 10th–12th grade student participating in athletics for the first time
• An ECG completed within the last two years meets the requirement

Sudden Cardiac Arrest (SCA) is the immediate loss of electrical function of the heart caused by an abnormal heart rhythm called ventricular fibrillation. SCA occurs suddenly, without warning, and causes the heart to stop pumping blood to the body. Sudden Cardiac Arrest is not the same as a heart attack.

The human body, including the heart, changes during puberty in a variety of ways. Because of these physical changes and the increased stresses on an active young heart, a cardiac screening should be part of a physical at least every two years.
Electrocardiogram (ECG) screening can help detect problems before they become major medical issues. While we recommend all students get an ECG, your child should definitely be screened if they:
● Have a family history of heart disease or SCA
● Experience dizziness or fainting spells during or after exercise/activity
● Experience extreme fatigue or unusual shortness of breath during or after exercise
● Experience chest pain during exercise
● Experience racing or irregular heartbeats

An ECG screening with WWPF is $20 compared to a doctor’s appointment with an ECG which may cost $150 or more. It is our core belief that every child deserves to have their heart checked so we will continue to offer these screenings as affordable as possible. Our goal is that no child will be turned away due to lack of funds.

Cardiac screening with an ECG can detect a variety of potentially fatal diseases that disturb a heart’s normal electrical function such as Hypertrophic Cardiomyopathy (HCM), Long QT Syndrome, and Wolff-Parkinson-White Syndrome (WPW). An ECG records the electrical activity of the heart and measures the electrical signals the heart uses to contract and circulate blood through the body and lungs. An ECG involves placing electrodes on the chest around the heart to record those signals. Once the screening is complete, a cardiologists will review your child’s ECG to make a determination on your child’s heart health. The test is easy, painless, non-invasive, and takes less than 5 minutes to perform. It does not involve needles, blood work, radiation exposure or sedation.

Statistics show that 1 in 300 youth have an undetected heart condition that puts them at risk for SCA. Statistics also show that 1 in 500 youth have a heart condition called Hypertrophic Cardiomyopathy (HCM) which is the most common cause of Sudden Cardiac Arrest/Death in people under the age of 30. If our cardiologists determine your child’s ECG is abnormal their consultation will most often include a recommendation for an echocardiogram (Echo) to take a better look at the heart. The Echo is used to get a picture of the heart, similar to an ultrasound used to look at a baby during pregnancy. The Echo looks for heart valve and vein structure abnormalities, muscle thickness, and proper heart function.

Who We Play For has a team of cardiologists that read every electrocardiogram WWPF performs. They have many years of experience and are qualified to read according to the International Criteria.

Yes. After the ECG is interpreted, the results will be returned to you within 10 business days identified as either low risk, follow-up, or high risk. A copy of the ECG will be returned along with information about the potential abnormalities our cardiologists identified and how you should proceed with your child’s medical care. Low risk results are returned via email. Any abnormal results will receive a phone call from a WWPF Heart Health Advocate to walk through the findings. Once your child’s ECG is returned, we encourage you to share it with your child’s pediatrician so they can add it to your child’s medical records.

An abnormal ECG flagged as follow-up means additional testing is needed to see what is causing the abnormality identified on the ECG – think of it as a yellow caution light. The consultation will include documentation on what the potential abnormalities may be as well as resources with cardiologists serving your community that you can connect with to continue your child’s medical care. If your child is flagged as follow-up, typically he or she can continue participating in the school’s sports program and their normal exercise/activity routine. However, per our cardiologist’s medical direction your child needs to visit a cardiologist within 3 months to determine why their ECG was abnormal.

If your child is flagged as high risk, it is like a red traffic light. He or she should not participate in sports or exercise/activity in any way (practice, games, scrimmages, etc.) until he or she has seen a specialist and received clearance or treatment. WWPF will provide you with resources with cardiologists serving your community that you can connect with to continue your child’s medical care.

The cardiac exam of the annual physical is limited to family and personal health history questions, and requires a doctor to listen to the student's heart with a stethoscope. Studies have shown that this is just 1% effective at identifying abnormalities that may lead to SCA. The addition of an ECG screening can increase the effectiveness up to 80-95%. WWPF’s cardiologists have special training and years of experience with pediatric ECGs, which results in more accurate exams.

ECG screening should be a part of the physical at least every other year through middle school and high school due to the physical changes and increased stresses on a developing youth’s heart, which occur during that time frame. However, encourage your children to be open and honest about how they physically feel and if at any time your child begins to experience any of the symptoms listed above, take immediate action with your child’s physician.

No, boys and girls must be screened separately so arrangements are made for privacy. Boys and girls may need to remove their shirts. Girls, however, should wear a regular bra or sports bra, which will not need to be removed.

You can visit the website contact page: www.whoweplayfor.org.