School Physical Examinations/Immunizations

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Get Your Child’s School Physical Exam at Kathy’s Urgent Care!

No Appointment Needed!

Walk-In 7 Days/Evenings a Week!


State of Connecticut Requirements

Connecticut’s State Department of Education (SDE) requires a completed Early Childhood Health Assessment Record be in file for all children, ages birth – 5, who are enrolled in day care, pre-school, pre-K, or Kindergarten programs.

Early Childhood Health Assessment Record

This form consists of three parts:

  • Part I – a comprehensive health history and indications of concerns, to be completed by a parent or guardian.
  • Part II – a medical evaluation to be completed by a health care provider (MD, DO, APRN, or PA) that includes a physical exam, screenings (visual, hearing, tuberculosis testing, dental, blood, and developmental assessment).
  • Part III – an immunization record to be completed by a health care provider. Required immunizations are extensive (a complete list can be found on a copy of this form).

Failure to comply with these requirements may prevent your child from being admitted to the desired program.


Health Assessment Record (for all students, K-12)

This form consists of three parts:

  • Part I – a comprehensive health history and indications of concerns, to be completed by a parent or guardian.
  • Part II – a medical evaluation to be completed by a health care provider (MD, DO, APRN, or PA) that includes a physical exam, screenings (visual, hearing, tuberculosis testing, dental, blood, and developmental assessment).
  • Part III – an immunization record to be completed by a health care provider. Required immunizations are extensive (a complete list can be found on a copy of this form).

Important: An immunization update and additional health assessments are required in the 6th or 7th grade and in the 9th or 10th grade, depending on your local school’s policy.

Failure to comply with these requirements may prevent your child from being admitted to school.

Exemptions

Connecticut permits two types of exemptions from immunization: (1) medical exemptions, and (2) religious exemptions. One of the following forms should be filed with your local school officials to claim an exemption.

Connecticut Department of Public Health Medical Exemption Certification Statement. This form must be accompanied by a letter from a licensed physician stating which immunizations should not be administered and why. The letter must include the child’s name, birth date, and the physician’s signature and contact information.

Connecticut Department of Public Health Religious Exemption Statement. To claim this exemption, the form must be filed before the child enrolls in a public or non-public school for the first time and before entering the 7th grade.

Important: Children who have been granted exemptions may be excluded from school until the danger of an outbreak of a disease has passed, or until the child has completely recovered from a disease, or the child is immunized.

Sports or Athletic Activity Physicals

The Connecticut Interscholastic Athletic Conference (CAIC) requires annual physical examinations of all students who participate in interscholastic sports. The following form must be completed by a health care provider and filed with the appropriate school district before a student is allowed to try out for or participate in interscholastic sports activities.

Pre-participation Physical Evaluation. This form must be completed and submitted annually.

Making the Process Easier

At Kathy’s Urgent Care, we try to make completing your child’s required health examination and immunizations as easy as possible. The following steps will help us to move things along.

  • Download, print, and fill out Part I of the appropriate form, one for each child. Early Childhood Health Assessment Record. Health Assessment Record (for all K-12 students).
  • Reserve an examination time at one of our two convenient locations.
  • Bring your health assessment form(s) with you.
  • Collect and bring all immunization records for each child.
  • Bring your child’s health insurance information and ID.

Don’t Wait Until the Last Minute!