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Health Form Requirements for Full Members


Full Member 1st graders need:

  • Health Exam for School Entry (or waiver)

  • Immunization Records (or waiver)

7th graders need:

  • Immunization Record showing T-DAP booster (or waiver)


Full Member Families with students entering the 1st or 7th grade need to submit the completed health forms linked below (also available in your Google Drive Folder). These forms will be kept, as legally required, with the student’s school records. The deadline to submit these forms is Friday, August 30th 2024. Please note that a doctor's appointment may be required-- make an appointment now so that you will have these items before the due date. Please print the health exam forms and bring to your appointment. Late fees apply to health forms not received by the due date. 


Report of Health Examination for School Entry 

(For incoming 1st grade students ONLY)

Health Exam Entry Form (click here)  

This needs to be completed for all incoming 1st grade students by their pediatrician. Please print this form and bring it with you to your appointment.


Waiver Form for Health Exam (click here) 

This is to be completed for all incoming 1st grader students by parents who do not wish to have their child receive a health examination as part of California’s school entry requirement.



Immunization Records

(For incoming 1st grade students & 7th grade students) 

An Immunization Record

(yellow card copy or printed list of immunizations from your child’s doctor) will need to be turned in for all 1st graders and proof of the Tdap vaccine requirement for all 7th graders. Your child's immunizations list may be available to download from your health provider's website. 

**If your child has had any vaccines, this form will need to be submitted even if you are waiving additional immunizations.


VAEB Waiver Form for Immunizations 

HSLDA secured an amendment to the bill SB 277 that now excludes the vaccination requirements for all private schools based in the home (private home schooling) which includes both private schools made up of one family and private school satellite programs for multiple families. (New law as of July 1st, 2016)