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Health Forms

• Dental Screening Form 8/26/22
• Diet Modification Request Form 2024
• Certificate of Immunization 2024
• Immunization Requirements (rev July 2024)
• Medical Certificate of Immunization Exemption (v2024)
• Medication Permission Form (English v1/25)
• Medication Permission Form (Spanish v1/25)
• Preschool, Transitional Kindergarten and Kindergarten Physical form
• Religious Certificate of Immunization Exemption (v2024)
• Sports Heads Up Concussion Form
• Sports Medical Release for injury
• Sports Physical Form
• Vision Screening 2024

PRESCHOOL

• Current Preschool/TK/Kindergarten Physical Form 

• Updated immunization record on file (Immunization Requirements) 

• Or a copy of religious exemption form or medical exemption form.

• Copy of birth certificate or other proof of date of birth to the office secretary

• Packets with the forms will be sent for preschool round-up

• Accidents happen! Be sure to have a spare set of clothes, weather appropriate, for your younger students available at school. 

TRANSITIONAL KINDERGARTEN

• Current Preschool/TK/Kindergarten Physical Form 

• Up to date “Kindergarten” vaccines (Immunization Requirements) DTaP Polio MMR Varicella. 

• Or a copy of a religious exemption form or medical exemption form.

• Dental Screening Form

• Vision Screening Form

• Copy of birth certificate or other proof of date of birth to the office secretary

• Accidents happen! Be sure to have a spare set of clothes, weather appropriate, for your younger students available at school. 

KINDERGARTEN

• Dental Screening Form

• Vision Screening Form

• Current Preschool/TK/Kindergarten Physical Form

• Up to date “Kindergarten” vaccines (Immunization Requirements) DTaP Polio MMR Varicella. 

• Or a copy of a religious exemption form or medical exemption form.

• Have at least one blood lead test before the child is 6 years of age (Check with your child’s healthcare provider)

• Copy of birth certificate or other proof of date of birth to the office secretary

• Accidents happen! Be sure to have a spare set of clothes, weather appropriate, for your younger students available at school. 

All forms are available on the District site at ahstwschools.org. TK/Kindergarten packets with the forms will be sent home with your child before the end of the school year.

1st-2nd GRADE

• No required items

• Accidents happen! Be sure to have a spare set of clothes, weather appropriate, for your younger students available at school. 

3rd GRADE

• Vision Screening Form

4th-6th GRADE

• No required items

7th GRADE

• Tdap and Meningococcal Vaccine prior to the first day of school. (Immunization Requirements)

• Or a copy of a religious exemption form or medical exemption form.

• If participating in sports your child will need a Sports Physical Form and Concussion Form.

8th GRADE

• If participating in sports your child will need a Sports Physical Form and Concussion Form.

9th GRADE

• Dental Screening Form provided by DDS/DMD or RDH

• If participating in sports your child will need a Sports Physical Form and Concussion Form.

10th-11th GRADE

• If participating in sports your child will need a Sports Physical Form and Concussion Form.

12th GRADE

• Meningococcal Vaccine  (Immunization Requirements 2nd dose after age 16) prior to the first day of school

• Or a copy of a religious exemption form or medical exemption form.

• If participating in sports your child will need a Sports Physical Form and Concussion Form.

Other Health Information for ALL Grade Levels:

• ALL students: need an up-to-date Certificate of Immunizations or an exemption form on file prior to the first day of school. 

• Scheduled vaccines are due in Kindergarten, 7th grade and 12th grade and must be turned in before school starts. Immunization Requirements or a copy of a religious exemption form or medical exemption form.

• ALL 7-12th grade students who participate in sports, including cheerleading, must have a new Sports Physical Form and Concussion Form on file before starting practice every year. They expire after 13 months.

• ALL students must have a health history form filled out online. This is done during registration in JMC. Please update as needed with any health changes throughout the year.. 

• Medication at school:  All medication must come in the original container with the pharmacy label with your student’s name, medication name, dose, route and frequency. Parents will deliver prescription medication to school, to ensure the safety of all children. A Medication Permission Form must be filled out for each medication taken at school, including rescue medication.

• Asthma: Students that have asthma need to have an Asthma Action Plan from their doctor’s office.(Needs to be updated every school year). ***Your student’s doctor must sign off on the bottom of the Medication Permission Form in order for your student to “carry” their inhaler or keep it in the classroom. (Typically 4th grade and up).  

• Epi-pen: Students that have an allergy that requires an epi-pen need to have their healthcare provider complete an Anaphylaxis Action Plan from their doctor’s office. (food allergy, bee sting, etc) (Needs to be updated every school year) Medication Permission Form 

• Seizures: Students that have epilepsy are required to have a Seizure Action Plan completed by their Healthcare provider. (Needs to be updated every school year) Medication Permission Form if prescribed a rescue medication.

• Diabetes: Students that have diabetes need their doctor to send Diabetes School Orders. (Needs to be updated every school year and as changes arise)

• Special Diet: Students that require a special diet need their Healthcare Provider to complete a Diet Modification Request Form (Complete one time and update only when changes occur).

Please reach out with any questions!

Kaleigh Lane RN

AHSTW PK-12th Grade School Nurse