Dear Parents/Guardians of Incoming 11th Grade Students,
The Pennsylvania School Health Law requires that all students receive a physical examination on entrance to school for 11th grade. A physical examination is also required for students in other grades who have no record of an examination on file. This exam can be dated anytime during the 12 months prior to the start of the mandated exam school year. As an example, if your child will be starting 11th grade on August 27, 2019, the physical exam can be dated anytime from August 27, 2018.
We also wanted to make you aware of the regulations that require students to have a second meningococcal vaccine (MCV4) by the first day of their 12th grade school year. This immunization can be administered after the age of 16. Please be certain that any immunizations administered at this physical exam be included in the documentation you return to school.
· Take the form with you to your appointment. If you forget the form, there is typically an additional charge to have it completed at a different time. A copy of a camp physical, athletic physical, or driver’s license physical form will suffice in lieu of the District form.
· Be sure that any immunizations administered at this appointment are written on the form.
· Return the form to school as soon as it is completed. If completed prior to the end of the 2018-19 school year, the document can be sent to NAI. After that time, please send it to NASH.
If you are unable to pay for an examination by your primary care provider, please sign below and return this form to the school nurse who will schedule your child for a physical exam by the School Physician or Certified Registered Nurse Practitioner.
I _____________________________ (parent/guardian name), do permit my child, ______________________________ (student name and ID) to receive a medical examination by the School Physician or Certified Registered Nurse Practitioner.
You can view your child’s health information, including immunizations, via the Tyler SIS parent portal. You will be able to view documentation for any exams and immunizations provided to school.