South Carolina H 4746: Physicals and EKGs for student athletes

Bill Text

2025-2026 Bill 4746 Text of Previous Version (Dec. 17, 2025) - South Carolina Legislature Online 

South Carolina General Assembly
126th Session, 2025-2026

Bill 4746

Indicates Matter Stricken
Indicates New Matter

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A bill

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 
59-63-77 SO AS TO REQUIRE STUDENTS IN GRADES SEVEN THROUGH TWELVE WHO 
PARTICIPATE IN INTERSCHOLASTIC ATHLETICS TO RECEIVE AN ANNUAL PHYSICAL 
EXAMINATION BEFORE PARTICIPATION AND A ONE-TIME ELECTROCARDIOGRAM BEFORE 
INITIAL PARTICIPATION, TO PROVIDE FOR EXEMPTIONS, LIABILITY LIMITATIONS, AND 
SCHOOL DISTRICT DUTIES, TO REQUIRE GOVERNING BODIES OF INTERSCHOLASTIC 
ATHLETICS TO CONFORM THEIR BYLAWS, AND TO PROVIDE FOR EFFECTIVE DATES AND 
APPLICABILITY.

Be it enacted by the 
General Assembly of the State of South Carolina:

SECTION 1. Article 1, Chapter 63, Title 59 of the S.C. Code is 
amended by adding:

 Section 
59-63-77. (A) For purposes of this 
section:

 (1) 
"Student athlete" means a student in grades seven through twelve enrolled in a 
public school in this State who participates in interscholastic athletics.

 (2) 
"Healthcare provider" means a person who is:

 (a) 
a licensed physician authorized to practice medicine in this State pursuant to 
Article 1, Chapter 47, Title 40;

 (b) 
a licensed advanced practice registered nurse (APRN) authorized to practice in 
this State pursuant to Chapter 33, Title 40, excluding certified registered 
nurse anesthetists; or

 (c) 
a licensed physician assistant (PA) authorized to practice in this State 
pursuant to Article 7, Chapter 47, Title 40.

 (3) 
"Electrocardiogram" or "EKG" means a test that measures the electrical activity 
of the heart and is used to detect heart abnormalities.

 (4) 
"Participation" includes, but is not limited to, tryouts, optional or required 
conditioning and practices, athletic contests, and scrimmages conducted under 
the auspices of a school or school district.

 (5) 
"Physical examination" means a medical examination performed by a healthcare 
provider to assess a student's general health and physical fitness for 
participation in athletic activities.

 (B)(1) Beginning with the 2027-2028 School 
Year, a student athlete must complete the following before participation in 
interscholastic athletics:

 (a) 
An annual physical examination conducted within the twelve months preceding the 
start of each athletic season; and

 (b) 
A one-time electrocardiogram (EKG) prior to the student's initial participation 
in interscholastic athletics in grades seven through twelve.

 (2) 
Examinations required under this section must be conducted by a healthcare 
provider as defined in subsection (A)(2). A healthcare provider who administers 
or evaluates an electrocardiogram must be trained in the diagnosis, evaluation, 
and management of electrocardiograms.

 (3) 
Documentation of compliance must be submitted to the student's school district 
prior to participation.

 (C)(1) A student is exempt from the 
requirements of this section if:

 (a) 
the student's parent or legal guardian submits a written objection to the 
examination or electrocardiogram based on sincerely held religious tenets or 
practices; or

 (b) 
a healthcare provider issues a certificate of medical exemption based on the 
student's individual medical condition.

 (2) 
If a student is exempt under this subsection:

 (a) 
there is no liability on the part of any person, school, school district, or 
governing body of interscholastic athletics for any injury or death to the 
student arising directly from an undisclosed medical condition that would 
likely have been revealed by the examination or electrocardiogram; and

 (b) 
the exemption does not impose a duty of care or a duty to warn on any such 
person or entity.

 (D)(1) A student athlete who receives an 
abnormal EKG result is prohibited from participating in tryouts, practices, or 
competitions until the student submits written medical clearance to the school 
district.

 (2) 
The medical clearance must be issued by a healthcare provider trained in the 
diagnosis, evaluation, and management of electrocardiograms.

 (3) 
There is no liability on the part of a school, school district, or governing 
body of interscholastic athletics for any injury or death to the student 
arising from a cardiac event following such clearance.

 (E)(1) Each school district shall make 
good-faith efforts to pursue public and private partnerships to provide 
electrocardiograms at low or no cost to student athletes.

 (2) 
A student athlete is exempt from the EKG requirement if the school district in 
which the student resides is unable to obtain a public or private partnership 
that provides EKGs at a cost of less than fifty dollars per student.

 (F) 
Any governing body of interscholastic athletics operating in this State shall 
revise its bylaws, rules, and proc