IMMUNIZATION CERTIFICATE
Please be aware that according to the new law, a new immunization form is now being utilized throughout the state of Kentucky. All health care providers should have copies but please remind them of this when obtaining any immunizations. Per state law, your school will not be allowed to accept any old immunization forms after July 1, 2011. Also, your school is not allowed to accept immunization records with only the most recent shot/s documented. The complete vaccination history must be listed.
Before Entering Preschool/Kindergarten
¨ Medical examination (School physical) before school entry.
¨ Vision Exam by Optometrist or Ophthalmologist for 3-6 year old school entry.
¨ All newly enrolled 5-6 year olds must have a Dental screening.
Immunization Certificate must include:
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DTaP |
Booster dose at 4-6 years - before school entry. |
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Polio |
Dose at 4-6 years - before school entry. |
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MMR |
Second dose - before school entry if child is age 5 or younger |
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Hib |
Minimum of one dose required if child is less than 5 years old. |
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Hepatitis A |
Two shot series - 12 mths - 18 yrs |
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Varicella |
2 doses required for school entry if child is age 5 or younger. Verification of a history of chicken pox has to be obtained from a physician. |
* Printable Exam Forms located below
Before Entering Sixth Grade
Medical examination before sixth grade entry.
Immunization Certificate must be updated to include:
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MMR |
Measles, Mumps, Rubella - A second dose is required if not already received. |
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Hepatitis B |
Three shot series - If not previously vaccinated. |
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Tdap |
Tetanus vaccine required for 6th grade if child is 11 or 12. If child received a TD (another form of tetanus) between the ages of 7 – 10, they are still required to have a Tdap for school entrance. One form of Tdap called Boostrix is actually approved to be given starting at age 10 but the form of Tdap called Adacel is only approved for ages 11 and up. |
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Meningococcal Vaccine |
Meningococcal Vaccine (for meningitis) is required for 6th grade school entrance if your child is age 11 or 12. The CDC recommends that the Meningococcal vaccine be given starting at age 11. |
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Varicella Vaccine |
A second dose of Varicella Vaccine (for chicken pox) is required for 6th grade school entrance if not previously obtained. If your child has a history of the chicken pox disease, state law requires verification from their health care provider.
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* Printed Exam Forms located below
High School Requirements
Tdap (Tetanus) - if student has not received a dose of Tdap since age 10, one dose of Tdap is recommended in high school.
Student Physical Form (REQUIRED PHYSICAL FOR ALL STUDENTS)
Athlete Physical Exam Form KHSAAAFORM2012 (THIS IS FOR STUDENTS PLAYING SPORTS AT SCHOOL)