Back to School Forms 

Medical Requirements & Immunizations

Submit to Brett Jaycox

In preparation for each school year and in compliance with the Department of Health, every parent or guardian must complete the following forms for each child. These forms are due by the end of the second week of school.


  • The Medical Examination Form must be completed by the student's physician and student's parents
  • Dental Certificate (received from your dentist's office). This form is required for grades K,2,4,6,8 and 10
  • PVAC-3 Form (Green Immunization Form) must be current and resubmitted as booster vaccines are administered. All children at ages 4, 11, and 16 require vaccines. Please see Birth-18 Years Immunization Schedule for CDC guidance.      
  • COVID-19 Vaccine Card if applicable. Please note that this is not a requirement but is strongly encouraged for eligible students. 
  • Epi-Pen is required for any student who is prescribed one. Please contact to coordinate a drop-off time. Please include a physical photo of your child attached to the prescription and specific allergies outlined on the child's medication examination form filled out by the child's physician. 
  • Asthma Treatment Plan must be completed for any child with a medical diagnosis of asthma. Please fill and return the following documents to the TD Health Center. Please ensure that all asthma-related medications are delivered to the TDHeath Center on the first day of school:

All completed forms can be emailed to indicating the child(rens) grade level. Forms may also be dropped off in a sealed envelope with the child's name and grade included with the security guards Monday thru Friday, 9:00 am to 2:00 pm.

Please always check the TD Health Center webpage for the latest information and updates regarding medical requirements and health protocols.

Secondary Forms (6-12) 

Submit to Annie Galatzán

If applicable:

Elementary Forms (PPK-5) 

Submit to Elsa Ramos

If applicable:

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