Below you will find information and health forms that are required for students each school year.
*All seniors will need the Meningococcal vaccine unless you have an exemption form.
For more information about immunizations, vaccine requirement and medication guidelines, please read the Health Information Guide.
- Medication Permission Form: required for students taking prescription medication or ‘as needed’ over-the-counter medication. Please read carefully.
- Activity Physical Form: required for any student involved in a school extra curricular activity including 6th Grade Dance
- Dental Screening Exemption Form
- Vision Form: required for Kindergarten and incoming 3rd graders
- Dental Form: required for all 8th graders entering 9th grade
- Concussion Form
Elementary/Secondary School, 4 years of age and older.
Diphtheria/Tetanus/Pertussis: 3 doses, with at least 1 dose of diphtheria/tetanus/pertussis-containing vaccine received on or after 4
years of age if the applicant was born on or before September 15, 2000; or 4 doses, with at least 1 dose of diphtherial/tetanus/pertussiscontaining vaccine received on or after 4 years of age if the applicant was born after September 15, 2000, but on or before September 15, 2003; or 5 doses with at least 1 dose of diptherial/tetanus/pertusis-containing vaccine received on or after 4 years of age if the applicant was born after September 15, 2003, and 1 time dose of tetanus/diphtheria/acellular pertussis-containing vaccine (Tdap) for the applicant in grades 7 and above if born after September 15, 2000; regardless of the interval since the last tetanus/diphtheria-containing vaccine.
Polio: 3 doses, with at leawst 1 dose received on or after 4 years of age if the applicant was born on or before September 15, 2003; or 4 doses with 1 dose received on or after 4 years of age if applicant born after Sept. 15, 2003. Polio vaccine nis not required for persons 18 years of age or older.
Measles/Rubella: 2 doses of measles/rubella-containing vaccine; the first dose shall have been received on or after 12 months of age; the second dose shall have been received no less than 28 days after the first dose; or the applicant demonstrates a positive antibody test for measles and rubella from a U.S. laboratory.
Hepatitis B: 3 doses.
Varicella: 1 dose received on or after 12 months of age if the applicant was born on or after September 15, 1997, but born on or before September 15, 2003, unless the applicant has had a reliable history of natural disease; or 2 doses received on or after 12 months of age if the applicant was born after September 15, 2003, unless the applicant has a reliable history of natural disease.
Meningococcal (A, C, W, Y): 1 dose of meningococcal vaccine received on or after 10 years of age for the applicant in grades 7 and above, if born after September 15, 2004; and 2 doses of meningococcal vaccines for the applicant in grade 12, if born after September 1999; or 1 dose if received when the applicant is 16 years of age or older.
New Vaccine Requirement for 7th, 12th Graders
Beginning with the 2017-2018 school year and thereafter, students entering seventh grade born on or after September 15, 2004, shall have one dose of meningococcal conjugate vaccine (A, C, W, Y).
Students entering twelfth grade born on or after September 15, 1999, shall have two doses of meningococcal conjugate vaccine (A, C, W, Y); or one dose if the dose was previously received when the student was 16 years of age or older.
There is no provisional period to implement this requirement if the seventh grade or twelfth grade student has received no meningococcal conjugate vaccine.
Additionally, all students entering, advancing to, or transferring into seventh grade and born on or after September 15, 2000, will require a one-time booster dose of tetanus, diphtheria and accullular pertussis containing vaccine regardless of the interval since the last tetanus/diphtheria containing vaccine.
Documentation of the vaccines on the Certificate of Immunization will need to be provided to your child’s school prior to the first day.
The following guidelines are to be observed if it is necessary for a student at any grade level to take medication (including Tylenol and cough syrup) at school. These procedures are fairly uniform for most schools. They were developed to minimize the potential for one student to “share” medication with another student or to leave medication carelessly about where another student might take it and have a severe reaction. We urge your full cooperation with these procedures to protect your student, as well as others who attend our school. It may make life a little more inconvenient, but we believe the safety of our students is worth the inconvenience.
If it becomes necessary for a student to take medication at school, these guidelines must be followed. Authorization for medications is
- Over the counter medication, such as Tylenol, Ibuprofen and cough medication can be given if sent in the original container and accompanied by dated, written permission from parents that includes why it needs to be given. Product label recommendations for administration will be used for medication dosage. If medication dosage needs to be given outside the guidelines of product labeling a doctor’s prescription needs to be provided.
- Prescription and non-prescription medications must be sent to school in the original pharmacy bottle with a medication label that includes student’s name, name of medication, directions for use, date and physician’s name. You may need to ask your pharmacist to give you two containers, one for school and one for home. Written permission from parent is also required.
- Self-administration of medication for students with asthma or other airway disease is allowed under the following guidelines. It is the provider and parent who will decide if the student is capable of carrying and using his/her inhaler. The school (nurse) will not be responsible for determining if the student is competent to use inhaler, nor will the school nurse have to record how often the student is using the inhaler. The school must have a written statement from the physician, physician’s assistant or advanced nurse practitioner indicating the need for the inhaler and permission to carry the inhaler at all times. The school must also have a written consent from the parent for the student to carry their inhaler at all times. The inhaler must have a prescription label on the inhaler itself, not the box. Students who fail to comply with the self-administration or abuse the privilege (example: incorrect technique, overusing, or sharing medication) can by law, have the privilege to carry an inhaler revoked. Authorization is reviewed annually. If changes occur in the medication dosage or time of administration, the parent is to notify school officials immediately.
- Medication that is prescribed for three times a day or less does not need to be given during the school day. We prefer, if it is okay with the physician that this medication be given before school, immediately after school, and at bedtime.
- On special occasions, such as field trips, when students are out of the building at the time their medication is scheduled to be given, their medication will be packaged and sealed in individual envelopes, labeled with the students’ name, name of the medication and time it is to be given. The supervising instructor will then dispense the medication at the appropriate time.
For self-administration of asthma or airway disease medication (inhalers or nebulizer treatments) a provider’s (physician, physician assistant, or nurse practitioner) recommendation and signature is required.
Please see the bottom of the Medication Permission Form.
A physical examination must be obtained from a doctor before any student is allowed to participate in athletics. Forms for this purpose are available in the superintendent’s office, the middle school and high school offices, and the district’s web page. Sports physical forms must be returned with the doctor’s signature before a student will be allowed to practice. Parents of students participating in school athletic programs must sign a form indicating they have adequate insurance (health & accident), or they must sign a form saying they accept full responsibility for expenses resulting from athletic injuries.