Requirements and Forms
From physicals, to dental exams, to immunizations, the state mandates that your child meet the standard health requirements for attending schools in Pennsylvania.
This page is meant to help you easily access and review information necessary to ensure your certified school nurse has the necessary information and forms to meet those standards and help serve your child well.
- Physical Exams
- Dental Exams
- Immunizations
- Health Screenings
- Emergency Card
- Medication Policy
- Parental Education of Type I Diabetes
Physical Exams
Physicals are required by the Pennsylvania School Code for school entry at Kindergarten and/or grade one (1) and at grades (six) 6 and eleven (11). When that is not possible, physical exams can be scheduled with the school physician. Information about this option will be provided by your school nurse if they have not received your physical form.
The Pennsylvania State Mandated Physical form as well as the Penn-Delco Health History Form should be provided directly to your school nurse.
Pennsylvania School Physical Form (English)
Pennsylvania School Physical Form (Spanish)
Penn-Delco Health History Form
Note: Your certified school nurse recommends that you take your child for annual check-ups with your private physician.
Looking for Required Forms for Athletics?
The PIAA Comprehensive Initial Pre-Participation Physical Evaluation Form is required of all student-athletes at NMS and SVHS. Visit the Athletics website to learn more.
Dental Exams
We recommend having your child see your own private dentist every 6 months. Dental forms are required by the Pennsylvania School Code for school entry Kindergarten (K) and grade one (1) and grades three (3) and seven (7). Please submit the completed dental form to the school nurse.
Private Dentist Report of Dental Examination of a Pupil of School Age
Immunizations
In Pennsylvania, school-age children must meet specific immunization requirements on the first day of school. Without the necessary immunizations or an approved medical or religious/philosophical exemption, children will be excluded from school. Additionally, in the event of an outbreak, unvaccinated students may be excluded from attending.
Key Steps for Families
- Consult Your Physician: Before the school year begins, consult with your child’s physician to ensure their immunizations are up-to-date.
- Submit Immunization Records: Provide an official immunization record from your doctor to your school's certified nurse.
- Schedule Appointments: If your child is missing required immunizations, schedule an appointment and send in the documentation.
- Medical Plan Form: If your child has not received the required doses, submit an immunization medical plan form (red and white card completed by a physician) within the first five days of school, or your child may be excluded.
Current Immunization Requirements:
- For attendance in all grades, 4 doses of polio (4th dose on or after 4th birthday and at least 6 months after previous dose given)
- For attendance in all grades, 4 doses of tetanus, diphtheria and acellular pertussis (4th dose on or after 4th birthday)
- For attendance in all grades, 2 doses of measles, mumps, rubella ( preferably given as MMR )
- For attendance in all grades, 3 doses of Hepatitis B
- For attendance in all grades, 2 doses of Varicella or chicken pox from vaccine or by history of disease
- For attendance in 7th grade, 1 dose of tetanus, diphtheria, acellular pertussis (Tdap) on the first day of 7th grade
- For attendance in 7th grade, 1 dose of meningococcal conjugate vaccine (MCV) on the first day of 7th grade
- For attendance in 12th grade, 1 dose of meningococcal conjugate vaccine (MCV) on the first day of 12th grade (If one dose was given at 16 years of age or older, that shall count as the 12th grade dose)
Please note that Penn-Delco's responsibilities relative to the enforcement of the law will be based on the following criteria:
- Proof of Immunization, rather than parent recall, is required
- The minimum required immunizations must be documented for enrollment into school unless there is a valid exemption.
- The immunization histories of all transfer students must be reviewed for completeness, and corrective action taken when necessary.
School Board Policy No. 203, Immunizations and Communicable Diseases
Immunization Medical Plan Form
PA Department of Health - School Immunizations
Health Screenings
Pennsylvania state law mandates specific health screenings for students. In order to comply with the state's mandated health program, your school nurse will assess the following on an annual basis:
- Growth Screening: Height and weight are recorded annually for each student.
- Vision Screening: Vision screening, both for near and far vision, is completed annually for all students. Color and depth perception are assessed in grades 1 and 2.
- Hearing Screening: Hearing screenings are done annually for those students in kindergarten and in grades 1, 2, 3, 7 and 11.
- Scoliosis Screening: Scoliosis screening, a mandated screening for spinal curvature, are done in grades 6 and 7.
- Body Mass Index (BMI): BMI is a screening tool used to assess children at risk for being underweight or overweight. BMI is calculated based upon body weight, height, age and gender data. BMI in children is age-specific and gender-specific. Your child is not given this information at any time. The school nurse makes the calculations after the child's health screening session and notes this information in your child's school health record. This medical record is kept confidential. If at any time you would like this information, please reach out to your school nurse.
Parents will be notified if their child's health screenings reveal any concerns or abnormalities. In these instances, your school nurses will provide a referral for to the parent to follow up.
Emergency Card
Students must have a completed emergency card on file with the nurse’s office and main office. The card allows for emergency medical treatment and the release of information to staff. It should list a local contact person who can take responsibility if needed.
Emergency cards are updated annually. Notify the school of any changes to contact information, and if you'll be away for an extended period, provide alternative emergency contacts in writing. Accurate information is essential for effective emergency response.
Medication Policy
There is a nationwide awareness and concern for the increase of in-school dispensing of medication including a broad spectrum of patent medicines. In keeping with the district’s educational effort to encourage precaution and restraint in this important aspect of daily health care, the Penn-Delco School Board adopted the following policy:
- Physician orders should be renewed annually at the beginning of each school year.
- The Certified School Nurse, RN or designee shall be responsible for administering emergency medication as directed by a permission to administer medication form as directed by a student's physician (restricted to injectable adrenalin).
- Acetaminophen, Ibuprofen, Antacids and Antihistamines (for allergic reaction only) are the only authorized medications supplied in the school. These may be administered by the school nurse with parental permission on the emergency card.
- In compliance with the policy, a copy of the current prescription (renewed annually), signed by the child's local physician, must be on file in the nurse’s office.
- Medications to be administered MUST be identified in a pharmacy provided prescription container (not plastic bags, envelopes, etc.) and stored in the school nurse’s office. The prescription container is required for the nurse to administer prescribed medication to a student in school.
- All OTC medications except those listed on the emergency card, must have a physician’s order and must be supplied by the parents.
- Students are not permitted to carry any medication or pills. All medication/pills (including prescription, over-the-counter (OTC), diet preparations and dietary supplements and vitamins) must be brought to the nurse’s office in the original packaging, by the parent, (unless other arrangements are made with the nurse), administered under the supervision of the nurse or designee and stored in a secure location within the nurse’s office. Medication which is ordered “3 times/day” can usually be administered at breakfast, upon return from school and at bedtime.
- It is wise to notify the school nurse of all the medications your child is taking in case he/she develops an allergic reaction or incompatibility.
- At the end of the school year, unused medication will be returned to the parent or discarded.
A permission form for administering medicine outside of authorized medications supplied in the school is necessary to administer any medication. This form must be sent with your child on the first day of each school year or at the time a new medicine is required to be administered.
Self-Administration of Inhalers and Epi-Pens
Middle and high school students may carry inhalers and epi-pens if approved. The school nurse must supervise and periodically evaluate the student’s technique and self-assessment skills.
To carry these medications, a district form completed by both the physician and parent is required, confirming the student can self-administer. For inhalers, the physician must specify the medication name, purpose, dosage, frequency, and conditions for reporting to the nurse. For epi-pens, if used, 911 will be called immediately. Students must carry their medication to all off-campus school-related activities.
PDSD Permission to Administer Medications Form
Parental Education of Type I Diabetes
This type 1 diabetes information was developed pursuant to the Pennsylvania School Code (24 P.S. § 1414.12) and is for school entities and nonpublic schools to provide to parents and guardians of incoming elementary school students and students entering grade six, beginning with the 2025-2026 School Year.
Type 1 diabetes in children is an autoimmune disease that can be fatal if untreated, and the guidance provided in this information sheet is intended to raise awareness about this disease.
Act 117 - Parental Education of Type 1 Diabetes Webpage (PA.gov website)