Medical Forms

Private or School Physical Exam

Private or School Physical Exam and Private Dentist Report

It is a Pennsylvania state law that children entering Kindergarten (and all new students) must have a physical and dental examination (filled out and signed by doctor/dentist).

No additional forms required for returning students. 

No additional forms required for returning students. 

Private Dentist Report
It is a Pennsylvania state law that children entering 3rd grade have a dental examination (filled out and signed by dentist).

No additional forms required for returning students.

Sports Physical Examination
It is a BACS requirement that all students who wish to participate in the Extra PE program have a sports physical examination (filled out and signed by doctor).

Private or School Physical Exam and Sports Physical Examination
It is a Pennsylvania state law that children entering 6th grade have a physical examination.
It is a BACS requirement that all children who wish to participate in the Extra PE program have a sports physical examination. (filled out and signed by the doctor).

Private Dentist Report and Sports Physical Examination
It is a Pennsylvania state law that children entering 7th grade have a dental examination (filled out and signed by the dentist).
It is a BACS requirement that all students who wish to participate in the Extra PE program have a sports physical examination (filled out and signed by the doctor).

Sports Physical Examination
It is a BACS requirement that all students who wish to participate in the Extra PE program have a sports physical examination (filled out and signed by the doctor).

The Private Physical Examination of School Age Student is a Pennsylvania state requirement for all Kindergarten, 6th grade students and new students. The Private Physical Examination was revised by the state 9/12. The first page is a health history that is filled out by the parents. The physical exam and vaccine records should be filled out and signed by the doctor.

The Sports Physical Evaluation is required for all students, 5th – 8th grade, who want to participate in the Extra PE program. This form must be filled out and signed by your child’s doctor and is good for the entire school year.

The Private Dentist Report is a Pennsylvania state requirement for all Kindergarten, 3rd grade and 7th grade (and all new students in other grade levels).

Children in all grades (K-8) need the following immunizations for attendance:

• 4 doses of tetanus, diphtheria, and acellular pertussis
• 4 doses of polio
• 2 doses of measles, mumps, rubella
• 3 doses of hepatitis B
• 2 doses of varicella (chicken pox) or evidence of immunity

Additional immunization requirements for entrance into 7th grade:

• 1 dose of meningococcal conjugate vaccine (MCV)
• 1 dose of tetanus, diphtheria, acellular pertussis (Tdap booster)

Children who are not fully immunized according to the requirements set forth by the state of Pennsylvania must have a signed exemption statement citing the reason why vaccines were not given. If your child is exempt from immunizations he or she may be removed from school during an outbreak.

The Statement of Exemption to Immunization card is available at the school office for new parents who might want to choose this option. These cards are available to other parents upon request.

Exemptions to the school laws for immunization include:

• medical reasons
• religious reasons
• philosophical or strong moral or ethical conviction