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Although a standardized form is not required, the below information is required:

For children entering kindergarten:
• immunization records and proof of physical exam from doctor
• proof of dental exam from dentist

For children entering 3rd grade:
• proof of dental exam from dentist

For children entering 6th grade:
• immunization records and proof of physical exam from doctor

For children entering 7th grade:
• proof of dental exam from dentist

Immunization requirements, as mandated by the State of Pennsylvania are as follow for children entering school (kindergarten or grade 1):
• 4 doses of tetanus* (one dose on or after the 4th birthday)
• 3 doses of polio
• 4 doses of diphtheria (one dose on or after the 4th birthday)
• 2 doses measles*
• 1 dose of rubella (German measles)**
• 1 dose of mumps**
• 3 doses of hepatitis B
• 1 dose of varicella (chickenpox) vaccine or history of the disease


*usually given as DTP or DtaP, or DT or Td
** usually given as MMR

 

 

Phone: 610-566-6881 . Fax: 610-566-3910   |  FRANKLIN & GAYLEY STREETS | MEDIA, PA 19063