Immunization Information

Please ask your physician for a Form 14. All items below must be included on this form.

Each child must meet the following health requirements before attending school.

Immunizations

  • 4 DTaP, DTP, or Td
  • 3 Polio
  • 3 Hep B
  • 1 MMR
  • Hib
  • 1 Varicella

Physical Exam

  • Performed by a U.S. licensed physician, advanced practice registered nurse, or physician’s assistant within 12 months prior to the date of school entry.

Tuberulosis Examination

  • Mantoux/PPD (Tine test is NOT acceptable)
  • Performed by a U.S. licensed physician, advanced practice registered nurse, or physician’s assistant within 12 months prior to the date of school entry.