IMPORTANT INFORMATION REGARDING IMMUNIZATION REQUIREMENTS 2017-2018 SCHOOL YEAR Kindergarten through 12th Grade 5 doses (DTP) Diphtheria, Tetanus, Pertussis 4 doses Polio vaccine 3 doses Hepatitis B vaccine series (or alternate 2 dose series) 2 doses (MMR) Measles, Mumps, Rubella 2 doses Varicella (required for K through 9 th grade) 1 dose Varicella (required 10th through 12 th grade) Immunizations must be presented on a DH 680 state form. Also, any student entering Florida schools for the first time must present a School Entry Health Exam (form DH 3040) performed within the last 12 months prior to enrollment. Students transfering from within the state of Florida or students who are considered homeless will be given a 30 day temporary exemption in order for immunization and physical records to be requested/obtained. **7 th through 12 th Grade** Additional requirements: 1 dose (Tdap) Tetanus-Diphtheria-Pertussis (7 th through 12 th ) IMPORTANT! Sixth (6 th ) graders must have a Tdap before entering 7 th grade. Immunization dates must be turned in to the school clinic on a DH 680 state form obtained at the time of immunization. Call your pediatrician, Health Department or local clinic today for an appointment- DO NOT DELAY!!
HEALTH REQUIREMENTS FOR STUDENTS ENTERING ST. LUCIE COUNTY SCHOOLS SCHOOL HEALTH EXAMINATION (to comply with Florida statute 1003.22) Any student entering Florida schools for the first time (initial enterers and students transferring from another state or another country) must present proof of a School Entry Health Examination performed within the last 12 months prior to enrollment in school. The Student Physical Examination Form DH 3040 is the acceptable form and is in circulation in physician s offices and the county health units. If a student presents a physical examination report performed in the last 12 months that is similar to the DH 3040 form with much of the same health information included, that form can be accepted. If there is any question as to whether the form is acceptable, do not exclude the child; the form should be set aside to be reviewed by the School Health Nurse. *A 30-day exemption may be granted at the school sites for students transferring to a SLC school from another county in Florida in order to allow records from the previous county to be requested and received or the parent or guardian to present the certificate to school officials. Also, students who are experiencing homelessness and students who are known to the department, as defined in s. 39.0016, shall be given a temporary exemption for 30 school days. The student will be temporarily excluded from school after the 30 days if an appropriate Health Examination form is not received from the previous county or provided to the school by that time. ** Students shall be exempt from the requirement of a health exam upon written request of the parent stating objections on religious grounds. IMMUNIZATION REQUIREMENTS (to comply with Florida statute 1003.22) Prior to attendance in Florida schools, each child must present, or have on file with the school, a Florida Certificate of Immunization (DH form 680) showing immunization compliance. When transferring from other counties within Florida the parent will be requested to sign a 30-day exemption form at the school site in order for the student to be admitted to class until the Certificate of Immunization is sent to the school from the previous school district or presented to the school by the parent. Also, students who are experiencing homelessness and students who are known to the department, as defined in s. 39.0016, shall be given a temporary exemption for 30 school days. School personnel are encouraged to assist parents in obtaining the required forms mentioned above by providing them with a list of cooperating physicians and clinics that provide school physicals and immunizations. Mandatory exclusion from school is required by Florida law after the expiration of the 30-day exemption and/or the immunization record is received and the student is not in compliance with the Florida state required grade/age appropriate immunizations. *NOTE: A 30 day immunization exemption for immunizations cannot be given to students if they are: 1) entering school for the first time (initial enterer). 2) transferring in from another state. 3) transferring in from another country. These students must provide the school with an updated Immunization Record (DH 680 form) certifying compliance with the Florida Compulsory School Immunization Law in order to be admitted or allowed to attend school. ** Students shall be exempt from the immunization requirement if they present to the school a valid DH Form 681 for religious exemption from immunizations. This form is obtained from the SLC Health Department. Parents can call 462-3800 for an appointment. 5/17
SCHOOL HEALTH REQUIREMENTS SUMMARY Students who are: Immunizations Requirements School Physical Requirements Notes Entering school for the very first time (initial enterers) Entering school from another country -must meet Florida state grade level requirements -should be submitted on a DH 680 form -must meet grade level requirements before entering, documented on a DH 680 form -physical must be done within a year prior to enrollment -Florida school physical form DH 3040 preferred -if an alternate form is used, it can be accepted if it is similar to the DH 3040 form -must have school physical DH 3040 done within a year before entering -if alternate form is used, it can be accepted if it is similar to the DH 3040 form If there is any question as to whether the physical form is acceptable, do not exclude the child; the form should be set aside to be reviewed by the School Health Nurse. If there is any question as to whether the physical form is acceptable, do not exclude the child; the form should be set aside to be reviewed by the School Health Nurse. Transferring from a school in St. Lucie County, including private schools Transferring from another county in Florida Transferring from another state in the U.S. -must meet grade level requirements -immunization record (DH 680) should be transferred in the cumulative record from the previous school All counties in the state of Florida have the same immunization requirements -Immunization records should be transferred from the previous school/county. The FASTER system can/should be used -parents are given a 30 day exemption form. If records are not received after 30 days, parent should provide a shot record on a DH 680 form within the next two weeks *Certified 680 Form may be available for print out on FLSHOTS website -must meet grade level requirements before entering, documented on a DH 680 form. Parents should be directed to get the dates transferred onto the correct form at their doctor, clinic or Health Dept -physical form (DH3040) or acceptable alternative should be transferred in the cumulative record from the previous school -Physical should be transferred from the previous school/county. The FASTER system can/should be used. -parents are given a 30 day exemption form. If records are not received after 30 days, parent should provide a physical preferably on a DH 3040 form within the next two weeks -physical must be done within a year prior to enrollment -Florida school physical form DH 3040 preferred -if alternate form is used, it can be accepted if it is similar to the DH 3040 form If transferring from a public school, the immunization dates and physical date should also be available on the Skyward health screen If the FASTER system is used, place a copy of the FASTER in the health record. Immunization dates should be entered on the computer health screen. A T (for transfer) can be entered for the physical if an exam date is not provided. If there is any question as to whether the form is acceptable, do not exclude the child; the form should be set aside for review by the School Health Nurse Considered homeless (as defined by FS 1003.01) -are given a 30 day exemption to allow for transfer of records or for obtaining required immunizations on a DH 680 form -are given a 30 day exemption to allow for transfer of records or for obtaining a physical Shot dates may be available for print out on the FLSHOTS website Additional notes: - Permanent medical exemption from any/all immunizations can be obtained from the child s doctor or clinic and documented on the DH 680 form, in the appropriate section and signed by the physician - Religious exemption for immunizations can only be obtained from the SLC Health Department and documented on DH 681 form - Exemption from health exam requires written request by parent based on religious grounds 5/16
IMPORTANT INFORMATION REGARDING IMMUNIZATION RECORDS (DH 680 S) 1) Refer to the current Immunization Guidelines Booklet and/or your RN for current compliance standards/requirements. 2) Check to see where the immunization form has been signed by the practitioner (front or back, depending on the form used) to see if the child s immunizations record has been declared complete or if there is a temporary medical exemption indicating that more shots are needed. This area will also indicate if the child has been given a permanent medical exemption. If it is questionable as to why there is a temporary date, have the RN review that record. 3) A religious exemption can only be obtained at the Health Department and is a separate form- HD Form 681. 4) All required shot dates must be accurately entered onto the SKYWARD Vaccination Screen. Be sure to put the correct immunization code and any temporary exemptions dates on this screen and update it as needed. Write or stamp entered on the upper right corner of the 680 form once you have entered the dates. This will help you keep track of which dates have already been entered. Immunization Codes and Descriptions 1 680 shows that all general immunization requirements for kindergarten have been met. 2 Temporary medical exemption requiring follow-up (date of follow-up is listed) 3 Permanent medical exemption (student cannot receive required doses due to medical reasons) 4 Permanent religious exemption (HD Form 681) 0 Child enrolled in this district fewer than 31 days (30 day exemption given to request/receive records from another Florida county) 8 This is only used for 7 th through 12 th graders who have received all of the 7 th grade requirements as well as the general requirements they had to have when entering school for the first time. Using SKYWARD Vaccination Report templates, you can run various types of reports to help you keep track and follow up on students who do not have all of the required immunizations. 5/16
Tdap Immunization Reminder Letter for 7 th Grade Date: 2 nd Notice 3 rd Notice To the Parent/Guardian of Our school records show that your child needs to have the Tdap (Tetanus, Diphtheria, Pertussis) immunization, before entering the seventh grade, to be in compliance with the Section 1003.22, Florida Statute and Rule 64D- 3.046, F.A.C. If your child has already received the immunization above, please send the completed DH 680 form to the school clinic as soon as possible. For records/audit purposes the DH 680 form should include all immunization dates, including the Tdap booster date. If your child has not received the above immunization, please take this letter along with your child s shot record to the physician or clinic so that the proper immunization can be administered. Thank you in advance for your attention to this matter. Health Paraprofessional 5/17
ST. LUCIE COUNTY SCHOOL HEALTH SERVICES HEALTH RECORD REQUIREMENT LETTER STUDENT DOB SCHOOL GRADE TEACHER DATE Dear Parent/Guardian: Florida law requires that all students entering and attending public and private schools have a physical exam and be immunized against the following diseases at designated grade levels: diphtheria, pertussis, tetanus, polio, measles, mumps, rubella, hepatitis B and varicella (chicken pox). A review of your child s school health record indicates that the following immunization dates are needed. The immunization dates circled are needed in order to complete your child s required immunizations. DTP/DTaP/DT dose # 1 2 3 4 5 Td/Tdap dose# 1 2 3 Polio dose# 1 2 3 4 5 MMR dose# 1 2 Measles dose# 1 2 Mumps dose# 1 2 Rubella dose# 1 2 Hepatitis B dose# 1 2 3 Varicella dose# 1 2 or documentation of chicken pox disease date needed Health records for the above named student are incomplete for the following indicated reasons: The temporary medical exemption expires/expired on / / No immunization dates were found in file or No DH 680 form is on file The immunization certificate (DH 680) is not signed/stamped The last dose of DTP/DTaP/Polio was given before your child was 4 years old There is less than 6 months between DTP series date(s) and the booster date(s) Tdap booster date is required if none received in past 5 years- (grade 7-12) Two doses of measles (MMR) vaccine are required- (K-12) First dose of MMR was given before your child was 12 months old Three doses Hepatitis B required (two doses if Merck adolescence vaccine used) Permanent Medical Exemption (obtained from your health care provider) is necessary to document a medical reason for any vaccine that is omitted from required immunizations. Religious Exemption certificate is required if your religious tenets require no immunizations. This certificate is available at the St. Lucie County Health Department. There is no physical examination on file or exam was done more than 12 months prior to date of initial entry into school or written statement for religious exemption is needed. The physical examination form on file has not been signed and/or dated by a licensed health professional An additional varicella date is needed to meet grade requirement. In order for your child to remain in school, you must provide official medical documentation of the indicated vaccines/disease date and/or physical examination no later than. Please take this letter with your child to your health care provider to assist with completion of the requirement(s). If you have questions or need further information, please contact the school clinic at. Thank you, White copy- parent 3/12 Yellow copy- clinic STS0099
SCHOOL BOARD OF ST. LUCIE COUNTY Expiration of Temporary Exemption for Immunizations Date: / / To the Parent/Guardian of Your child s temporary exemption expires/expired on / /. You must send documentation of updated immunizations on a Florida 680 Form by / /. Failure to comply with Florida law (F.S. 1003.22) will result in your child being temporarily excluded from school until appropriate documentation is submitted to the school. Your attention to this matter is appreciated. Fecha: / / HEALTH AIDE Para el padre/tutor de La exempción temporal de su hijo/a expira el / /. Usted debe enviar documentación de las vacunas actualizadas en el Formulario Florida 680 el / /. El incumplimiento de la ley de la Florida (F.S. 1003.22) resultará que su hijo/a sea excluido temporalmente de la escuela hasta que la documentación apropriada sea presentada a la escuela. Agradecemos su atención a este asunto. DEPARTAMENTO DE SALUD 5/15
Temporary Exemption Notice Log Sheet Letter Sent Student Name Teacher Needs: Expiration 1st 2nd 3rd Notes 6-20B 5/07
HEALTH RECORD REVIEW Check Sheet STUDENT DOB GRADE TEACHER PHYSICAL DTP POL HEPB MMR VAR EXPIRATION 1 ST LETTER 2 ND LETTER 3 RD LETTER
TEMPORARY EXEMPTION FOR IMMUNIZATION EXPIRES TEMPORARY EXEMPTION FOR IMMUNIZATION EXPIRES TEMPORARY EXEMPTION FOR IMMUNIZATION EXPIRES TEMPORARY EXEMPTION FOR IMMUNIZATION EXPIRES
St. Lucie Public Schools Expiration Notice of 30 Day Exemption / / School Date Grade To the Parent or Guardian of: Student Name / / DOB Florida law requires that all children entering and attending public and private schools have a physical exam and be vaccinated against various diseases at designated grade levels. Immunizations must be on a Florida 680 Form or transferred using the *FASTER system. The 30 day exemption for these records to be transferred from your child s school in a previous Florida county has expired for the following reason(s): School Entry Health Examination School records from his/her previous school arrived and no physical was transferred in the records or on the *FASTER record. School records from his/her previous school arrived and the physical does not meet Florida requirements. No records were received from the previous school and the 30 day exemption has expired. Your child will be temporarily excluded from school unless you provide the school with a physical exam by / /. Immunization Records School records from his/her previous school arrived and no immunization record was included or the immunization dates were not included on the *FASTER record. Immunizations are not compliant with Florida State grade/age requirements. The following shots are missing from your child s record: DTaP Tdap MMR Varicella Polio HepB No records were received from the previous school and the 30 day exemption has expired. Your child will be temporarily excluded from school unless you provide the school with immunization records on a Florida 680 Form by / /. Signature Date: / / STS0150 *FASTER- Florida Automated System for Transfering Education Records 5/16