According to guidance released from PDE for medical exemptions from state assessments, generally, if a student can receive instruction, then they are also able to participate in state assessments. However, the health and well-being of students should take priority in determining whether they can participate. Students may receive a medical exemption if they cannot participate in a state assessment during the testing window, including make-up dates, due to a significant medical event.  Examples include, but are not limited to, a student who is 1) receiving short-term medical treatment due to a medical emergency; or 2) seriously ill or has a medical condition that prevents them from receiving instruction during the testing window. A medical emergency is defined as a circumstance in which a student cannot take or finish taking the assessment during the entire testing window, including make-up dates, because of a recent significant medical event just prior to or during the annual testing window.  Examples of medical emergencies include, but are not limited to: serious injury; concussion; confinement to home or hospital with an acute condition, not a long-term home instruction or hospital instruction situation; the inability to interact with others without serious risk of infection or contamination; pregnancy with significant health complications or delivery just prior to or during the testing window; and a mental health crisis that prevents a student from receiving instruction. A note from a physician dated at least two weeks within the start of the testing window must be on file at the school. These records must be retained for three years. A serious illness or medical condition is defined as one in which the student is receiving active treatment for a life-threatening illness or medical condition and/or the associated recuperation.  A note from a physician must be on file at the school and must be retained for three years. To account for a student with a medical exemption, as defined above, the “Medical Emergency” bubble on testing documents should be used. Note: An assessment of a student’s medical condition must be made annually at the testing window for each content area.