DEPARTMENT OF HEALTH & WELLNESS

REQUIRED HEALTH INFORMATION 

On the following pages is the official health information required for every student entering grades PK through 12 in Framingham Public Schools. To begin school, your child will need documentation of the following:

You can submit the immunization record and supporting documentation by uploading it at the end of this form.

Thank you!

PRESCHOOL and KINDERGARTEN:

• A copy of your child’s most recent physical examination (MUST BE within the last 12 months)
• Preschool vision screening from health care provider (MUST BE within the last 12 months)
• Lead Screening
• TB Test Results or Risk Assessment Form

GRADES 1-12:

• A copy of your child’s most recent physical examination (MUST BE within the last 12 months)

CHILDCARE/PRESCHOOL:

Attendees Requirements listed in the table below apply to all attendees ≥for 2 years. These requirements also apply to children in preschool classes called K0 or K1.

GRADES KINDERGARTEN - 6:

• DTaP/DTP – 5 doses
  4 doses are acceptable if the fourth dose is given on or after the 4th birthday. DT is only acceptable with a letter stating a medical contraindication to DTaP
• POLIO – 4 doses
  the fourth dose must be given on or after the 4th birthday and ≥6 months after the previous dose, or a fifth dose is required. 3 doses are acceptable if the third dose is given on or after the 4th birthday and ≥6 months after the previous dose
• MMR - 2 doses 
  the first dose must be given on or after the 1st birthday, and the second dose must be given ≥28 days after the first dose; laboratory evidence of immunity is acceptable
• HEPATITIS B – 3 doses 
  laboratory evidence of immunity acceptable
• VARICELLA – 2 doses 
  the first dose must be given on or after the 1st birthday and the second dose must be given ≥28 days after the first dose; a reliable history of chickenpox* or laboratory evidence of immunity acceptable or physician documentation of the history of chickenpox.

GRADES 7 - 12:

• Tdap - 1 dose
  and history of DTaP primary series or age-appropriate catch-up vaccination. Tdap given at ≥7 years may be counted, but a dose at age 11-12 is recommended if Tdap was given earlier as part of a catch-up schedule. Td or Tdap should be given if it has been ≥10 years since the last Tdap
• POLIO - 4 doses 
  the fourth dose must be given on or after the 4th birthday and ≥6 months after the previous dose, or a fifth dose is required. 3 doses are acceptable if the third dose is given on or after the 4th birthday and ≥6 months after the previous dose
• HEPATITIS B - 3 doses
  laboratory evidence of immunity is acceptable. 2 doses of Heplisav-B given on or after 18 years of age are acceptable
• MMR - 2 doses
  the first dose must be given on or after the 1st birthday, and the second dose must be given ≥28 days after the first dose; laboratory evidence of immunity is acceptable.
• VARICELLA - 2 doses
  the first dose must be given on or after the 1st birthday, and the second dose must be given ≥28 days after the first dose; a reliable history of chickenpox* or laboratory evidence of immunity is acceptable.
• NEW MENINGOCOCCAL REQUIREMENTS
  GRADE 7-8 - 1 dose
  MenACWY (formerly MCV4) required. Meningococcal B vaccine is not required and does not meet this requirement.
  GRADE 11-12  - 2 doses
  The second dose of MenACWY (formerly MCV4) must be given on or after the 16th birthday and ≥ 8 weeks after the previous dose. 1 dose is acceptable if it was given on or after the 16th birthday. Meningococcal B vaccine is not required and does not meet this requirement.
   

Once your child has been assigned to a school, please make an appointment with the school nurse. Bring forms and immunization documentation to the appointment. The nurse will review your child’s health information. Your child can begin school once all required health information is received. 

Thank you for your cooperation.

In an emergency, if parents/guardians cannot be reached, the school is authorized to contact:

In the event of an emergency situation where parents cannot be contacted, I authorize the school to obtain medical/emergency treatment for my child.

The school physician for Framingham Public Schools, with the approval of the School Committee, and in compliance with the Massachusetts Department of Public Health Regulations (105 CMR 210.00) has authorized the district’s school nurses to administer the following over the counter medications during the school day:

• IBUPROFEN (Advil, Motrin)—for headaches, body aches, or menstrual cramps
• ACETAMINOPHEN (Tylenol)—for headaches, body aches, or menstrual cramps
• BENADRYL—for general allergy symptoms
• TUMS/MAALOX—for upset stomach or indigestion
• VISINE ALLERGY RELIEF - for eye allergy symptoms

To assure the safe administration of OTC medications to students during the school day, the school nurse will:

• Assess the student’s condition, current medication profile, history of allergies and evaluate the need for medication.
• Review the signed parent permission form, which is valid for one school year.
• Call the parent/guardian to confirm, when necessary, the time of the last dose given.
• Administer the correct dosage according to the physician’s written protocols.
• Document the medication administration in the electronic health record.
• Contact parents/guardians who have requested notification following OTC medication administration during the school day.

DEVELOPMENTAL HISTORY

ALLERGIES

MEDICATIONS:

If you have any questions or concerns, please get in touch with the Framingham Public schools - Department of Health and Wellness Phone: 508-626-9197 or click on the link below to access the staff directory.

Health and Wellness Directory by School

Thank you!