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Required Medical Forms

Required Medical Forms

All medications and completed medical forms must be brought to school by a parent or guardian by the first day of school. Medical forms are available for download below. To request a hard copy, please email office@politz.org or call 856-667-1013. Any student whose parent or guardian has not submitted the completed, state-mandated forms prior to the first day of school WILL BE EXCLUDED from school until all requirements are met. 

ALL New K-8 Students

All new students from Kindergarten-8th Grade must submit the Student Health History which is completed by the parent, and  Private Physician’s Exam Report completed by a doctor who has examined your child within 365 days of start of school. We will also need full vaccination records.

All New Preschool Students

All NEW preschool (Toddlers-PreK) students must submit the Student Health History completed by a parent, and PreSchool Physical Exam and Imm Rec. completed by a doctor who has examined your child within 365 days of start of school.

Flu Vaccine Requirement Letter

PLEASE NOTE: Per state law, all preschool students (aged 59 months and under) MUST provide documentation of a flu shot by December 31 of the current year. Failure to provide this documentation by December 31 will result in exclusion from school until documentation is provided.

All KINDERGARTENERS

All incoming Kindergarten students (even those currently at Politz)  must submit the Student Health History Form which is to be completed by a parent or guardian AND Private Physician’s Exam Report completed by a Physician within 365 days of start of school.

Requirements for All Sixth Graders

All sixth graders must provide documentation of Tdap and Meningococcal vaccinations prior to the first day of school. Please read this 6th Grade Parent Letter for information. If you child has an appointment with the doctor past the first day of school, a note from the doctor or an appointment card with the date of exam is required before the first day of school.

FORMS

Student Health History

Private Physician’s Exam Report

PreSchool Physical Exam and Imm Rec.

The following forms are only required for students needing Epi-pens, Asthma Medications or other daily medications to be administered in school: