Connecticut State Department of Education, Connecticut Department of Health and the Darien Board of Education have specific health regulations students must adhere to while enrolled in Darien Public Schools.

New students will not be admitted until a school nurse has reviewed the student’s completed physical exam/health assessment and immunization records. Students may be exempt from the State mandated immunization and physical examination requirements based on medical or religious grounds.

SCHEDULE OF REQUIRED PHYSICAL EXAMINATION / HEALTH ASSESSMENT
SCHEDULE OF REQUIRED IMMUNIZATIONS

• New students entering Kindergarten through 12th Grade must submit completed primary immunizations and physical examination/health assessment prior to school entrance. A physical examination/health assessment for a new student is acceptable if it was completed within the year prior to entry. i.e. physical examination/health assessment cannot be dated earlier than August 30, 2010 for entry into school on August 29, 2011.

• Pre-Kindergarten - Students entering pre-kindergarten must submit completed primary immunizations and physical examination/health assessment upon entry into the Early Learning Program and annually thereafter.

• ALL 6th Grade students must submit documentation of complete immunization update and physical examination/health assessment completed during the 6th grade year.

• ALL 10th Grade students must submit documentation of complete immunization update and physical examination/health assessment completed during the 10th grade year.

• *ALERT* IMPORTANT IMMUNIZATION CHANGES EFFECTIVE 8-1-11:

Pre-Kindergarten, Kindergarten and 7th Grade 2011-2012
The State of Connecticut Department of Education and Connecticut Department of Public Health have recently posted school entry immunization requirement changes for students entering Pre-Kindergarten, Kindergarten and 7th Grade effective August 1, 2011.

• Please note: 7th Grade students are students enrolled in 6th Grade during the 2010-2011 school year and entering 7th grade fall of 2011
Before being permitted to enter 7th grade a student must submit proof to the school nurse of having received the immunization according to the new state mandated immunization requirements to the school nurse prior to school entry.

Acceptable proof of documentation of the student’s up-to-date immunization history is a certificate from a physician or local health agency stating the date (Month/Day/Year) immunizations have been given. Another acceptable form of immunization documentation is the State of Connecticut Department of Education Health Assessment Record. The student’s health care provider should complete, sign and date the immunization history (page 3) of the State of Connecticut Department of Education Health Assessment Record. (See link below entitled: Physical Examination/Health Assessment forms to obtain The State of Connecticut Department of Education Health Assessment Record for grade K-12).

Click here for:

Physical Examination Requirements

Physical Examination/Health Assessment Record Forms:

ED191 Early Childhood Health Assessment Record

Health Assessment Record Form for Kindergarten – 12th Grade

Immunization Requirement Information

Immunization Requirement Changes effective 8-1-11 for students entering K, Pre K and 7th Grade 2011-2012

HIGH SCHOOL INTERSCHOLASTIC SPORTS PARTICIPATION HEALTH REQUIREMENTS

• Physical Examination / Health Assessment Form
Darien High School student athletes participating in an interscholastic sport must, in accordance with CIAC rules and the Darien Board of Education policies, have an annual Physical Examination/Health Assessment which certifies the athlete may participate in athletic activities and Competitive sports. This Physical Examination/Health Assessment must be current within 13 months of beginning tryouts, practice and competitive play and kept on file with the school nurse.

• DHS Coaches Athletic Emergency Form
Each sports season (fall, winter, spring) the student athlete and parent/guardian are required to complete and sign the DHS Coaches Athletic Emergency Form. Upon completion the student athlete needs to bring it to the school nurse to verify medical clearance to participate in athletic activities and competitive sports.

PRE-KINDERGARTEN THROUGH GRADE 12 - Additional Health Forms and Information

Student Health form Guidelines

Physical Activity Restriction Form

Authorization for Administration of Medicine Form

Health Screening Schedule* Please complete and return this form to school nurse if you do not want your child to participate in the DPS vision, hearing and postural screening program.

Request for Dental Assistance Form

Request for HUSKY Information

Out of town Emergency Form

Helpful Contact Numbers

Insect Allergy Health Forms

Food Allergy Health Forms