Dear Parent or Guardian:
If your child is entering any of the following grades, please note the medical forms needed. The
physical and immunization record must be brought in at registration or
by the first day of school or your child will not be allowed to start
school.
K or new students to the district:
1. Physical examination
2. Immunization record
Polio: 4 doses with the last dose after the 4th birthday
Diphtheria, Tetanus, Pertussis: 4 or more doses with the last dose after the 4th birthday
Measles, Mumps, Rubella: 2 doses with the first at 12 months of age and the second at least one month later
Hepatitis B: 3 doses
Varicella (Chickenpox): 2 doses or proof of having disease
3. Proof of lead screening or blood test
4. Dental examination
5. Vision examination
6.
Birth certificate: copy from the county courthouse in the county which
your child was born, this is not the certificate from the hospital
2nd grade - Dental Exam
6th grade -Physical, Tdap Vaccination, Varicella vaccination: (2 doses at least 28 days apart), Dental Exam
9th grade - Physical, Tdap Vaccination (regardless of date of last tetanus), dental exam
12th grade
-2 doses of Meningococcal vaccination, if first dose administered after
the age of 16, then one dose is required for school entry
I
appreciate your cooperation in keeping our school safe and healthy. If I
may be of any assistance or if you have any questions, feel free to
call me at 676-1521, ext. 333.
Thank you,
Jessica Brake, BSN, RN
PLEASE NOTE: No medication (even over the counter medication like Tylenol, Tums, Ibuprofen, etc.) will be given to a student without a signed "Permit to Give Medication" form on file.

Dental Safari is coming this spring. Download the forms and brochures here!