Immunization and Medical Forms
Immunizations
New York City Immunization Requirements, Letter, and Chart
As of June 13, 2019, public, private and parochial schools and child care programs in New York can no longer accept requests for religious exemptions from school immunization requirements. This law applies to students in pre-kindergarten through 12th grade and to all child care settings. Schools and child care programs will continue to accept medical exemptions.
Medical Exemptions: The Immunization Medical Exemption Form from the DOH must be used when parents are requiring a medical exemption.
This Medical Exemption Form must be given to the nurse upon receipt from the parents.
Medical Forms
NURSERY, PRE-K, AND KINDERGARTEN NOTICE
New York State Law requires that each child entering school in September in Nursery, Pre-K, and Kindergarten must have the following:
- A complete physical examination
- Complete immunization
In order for your child to be in full compliance, a complete physical examination form, with immunizations, must be submitted to the school.
Completed medical forms must be returned on or before September 6, 2023.
Please return all forms and immunizations to the school office. If you have any questions you can reach the school nurse at 718-474-4276. Thank you for your cooperation.
Allergy/Anaphylaxis Medical Administration Form
Asthma Medical Administration Form
Diabetes Medication Administration Form
General Medication Administration Form
Seizure Medical Administration Form
Request for Medically Prescribed Treatment (Non-medication)