Each year parents/guardians must complete the BACK-TO-SCHOOL FORM FOR OFFICE STAFF and BACK-TO-SCHOOL FORM FOR SCHOOL NURSE in PowerSchool, our District 18 student information system. Families will receive communication during the summer months prior to school entry, or upon registration, with instructions for entry of this very important information. This mandatory annual update is critical for school personnel to be able to contact families and for the school nurse to be able to meet the medical needs of students.

The State and local Board of Education require a physical exam for students in every year of preschool, kindergarten, grade 6, grade 9, and for all new registrants. 

Preschool students must use the State of Connecticut Department of Education’s Early Childhood Health Assessment Record (ED 191), which is available for download here: Early Childhood Health Assessment Record

Students in kindergarten, grade 6, grade 9, and new registrants must use the State of Connecticut Department of Education’s Health Assessment Record (HAR-3), which is available for download here: Health Assessment Record

Health assessments must be completed by a licensed physician, an advanced practice registered nurse (licensed in CT under chapter 378), a physician assistant (licensed in CT under chapter 370), a school medical advisor, or any of these professionals if they are stationed at a military base. All mandatory screening items are marked with an asterisk (*) and must be completed by the healthcare provider, including hemoglobin/hematocrit levels for all required physical, as well as lead screening for all preschoolers. The front page (Part 1) must be completed by the parent/guardian, and includes a release of information. 

Physical exams with up-to-date, state-mandated immunizations are required at the following times:

• Preschool: completed within 1 year prior to the first day of school, and again annually while enrolled in preschool. 
• Kindergarten: completed within 1 year prior to the first day of school.
• Grade 6: completed between June 1st of grade 5 and before starting grade 7.
• Grade 9: completed between June 1st of grade 8 and before starting grade 10.
• Transferring into the District:
  • New registrants from within the United States must submit a physical exam from their previous school that addresses the screening items that are required by District 18. 
  • New registrants from outside the United States must submit a physical exam conducted by a U.S. licensed healthcare provider, and the exam must be completed within 1 year prior to entry.  In addition to all of the mandatory health assessment requirements that are present on the State of Connecticut Department of Education Health Assessment Record, tuberculosis testing shall also be included for those who are from countries that are considered at high risk for the disease, as currently determined by the Centers for Disease Control.

Students who wish to participate in interscholastic athletics must provide evidence of a physical examination completed within 13 months prior to joining the team. Students are not permitted to practice or compete until this requirement is met. Students in grades 6 and 9 should use a State of Connecticut Department of Education Health Assessment Record (HAR-3). All others may use a Regional School District #18 Sports Physical Examination Form available for download here: Sports Physical Examination Form

State regulations require students to be immunized according to the current Connecticut Department of Public Health requirements. Proof of all mandated immunizations must be submitted to the school nurse prior to admission.
      IMMUNIZATION REQUIREMENTS FOR ENROLLED STUDENTS IN CONNECTICUT SCHOOLS
Where can I find a list of vaccines required by CT Law for my student to attend school?   
IMMUNIZATION REQUIREMENTS FOR ENROLLED STUDENTS IN CONNECTICUT SCHOOLS ‡ 
There were recent changes to the national childhood immunization schedule. Will there be changes to the immunization requirements for school?
No. Connecticut’s childhood immunization schedule and school requirements remain unchanged and continue to be based on long-standing, evidence-based recommendations consistent with state law and the established standard of care. For more information from the Department of Public Health, please see: Guidance on Connecticut’s Childhood Immunization Schedule and School Requirements (1/13/2026) 
What are the preschool flu shot requirements?

The Connecticut Department of Public Health’s influenza vaccine (flu shot) requirement for preschool students under age 5 is as follows:

• If the student has previously received a flu shot: One dose of the influenza vaccine is required between August 1 and December 31st.
• If the student has never received a flu shot: Two doses are required, at least 28 days apart. Both doses must be completed by December 31st.
• If the student is not up to date by the deadline: They will not be allowed to attend school during flu season (typically January-April at the discretion of the District Medical Advisor) until the required vaccination(s) are received.
• If the student turns 5 before December 31, 2025: The flu shot is not required, it is strongly recommended.

For more information, please see: DPH Pre-school Flu Immunization Requirement: Q+A 

What if my child was delayed with starting a vaccine schedule and is not fully vaccinated according to the guidelines? 
These cases must be reviewed and approved by the nursing department before the child is permitted to enroll in school. Conditional enrollment may be considered for children who have received all initial immunizations, received all subsequent available doses according to the CDC catch-up schedule, and commit to future doses being administered per the CDC catch-up schedule: Catch-up Immunization Schedule for Children and Adolescents (Addendum updated August 7, 2025). 

Students whose initial immunizations have been given but additional required immunizations are in process are required to submit to the school nurse for review:

1. Healthcare Provider’s Certification of In Process Required School Immunizations. 
2. A detailed appointment schedule for the remaining vaccines, completed by the student’s healthcare provider.
   
   Additionally, students allowed to enroll on a catch-up schedule must provide the school nurse with proof of each vaccine administered until all requirements are met. Failure to adhere to the CDC catch-up schedule, or to provide this documentation in a timely manner will result in exclusion from school until the required information is submitted.

What if my child has a medical exemption?
A secure, web-based portal has been established by the Connecticut Department of Public Health to collect medical exemption information. All medical exemptions that were issued on or after July 1, 2021, must be entered in the portal by the student’s healthcare provider who granted the exemption. The parent/guardian can download a pdf copy of the information in the portal, which must be given to the school nurse for review. 

Medical exemption status may be temporary or permanent. If a temporary medical exemption is not updated beyond its expiration date, the student may be excluded from school until either an updated form from the provider is received or the required vaccine dose is administered.
What happens if there is an outbreak of a vaccine-preventable illness?
In the event of a vaccine-preventable illness in the community, students who are not immunized or are under-immunized may be asked to stay out of school for the duration of the outbreak. For more information, please see: If you choose not to vaccinate your student, understand the risks and responsibilities.

Vision, hearing, and postural screenings are performed in schools as mandated by the CT State Department of Education. Students with documentation of recent screening by their primary care provider and/or specialist treatment may be excused from school screenings. Parents/guardians are to alert the school nurse in writing annually if they do not want their child to participate in school health screenings. 
Vision screening is required for students in grades K, 1, 3, 4 and 5. This noninvasive screening typically takes place towards the beginning of the school year. Its purpose is to identify students with potential visual difficulties that may affect learning and school adjustment. 
Like vision impairments, hearing loss also has educational implications. Hearing screening is required for students in grades K, 1, 3, 4, and 5. The purpose of hearing screening is to identify students with potential hearing loss and refer for treatment or intervention.
Postural screenings are required for female students in grades 5 and 7, and male students in grade 9. The purpose is early identification of postural abnormalities so that treatment can be initiated. 
Parents/guardians will be notified by the school nurse if their student’s screening is out of normal range and they are in need of further evaluation by a physician or specialist. 

The State of Connecticut has made potassium iodide tablets available to residents and workers within the 10-mile emergency planning zone around Millstone Power Station in Waterford, CT. All child care programs within a ten-mile radius of the Millstone Power Station must notify parents and guardians of enrolled minors, program staff and other persons present of the statutory requirement to distribute and administer potassium iodide to adults present or to a child in attendance during a public health emergency declared by the Governor. Programs must designate program staff members, eighteen years of age or older, to distribute and administer potassium iodide and shall instruct them in the administration of potassium iodide. Important information on the use of potassium iodide tablets from the Department of Public Health and the Department of Emergency Services and Public Protection can be found here:
State of Connecticut Department of Public Health AND Department of Emergency Services and Public Protection 1 A-REP-22 Potassium 
Every student must have a KI authorization form on file with the Health Office to remain in their cumulative health record. Potassium Iodide (KI) Student Medication Authorization Form

Medication shall be administered to students during school hours only when it is not possible to achieve the desired effects by administering the medication at home. If administration of prescription and over-the-counter medication is necessary during school hours and school activities, the following criteria must be met:

• A complete Authorization for the Administration of Medication (must be completed by healthcare provider and parent/guardian) for each medication. This form must be filled out and signed by the student’s healthcare provider, and include written authorization by the parent/guardian. The authorization expires after 1 year, or sooner if notated by the healthcare provider. 
• Medication must be dropped off in the Health Office by the parent/guardian. Please do not send medication to school with your child and do not send more than a 90-day supply. Medication must be in the original container, properly labeled, and not expired. Over-the-counter medication must be in the original container. Remaining medication must be picked up by the parent/guardian at the end of the school year, or it will be discarded.

Please note: students with an emergency medical condition requiring “rescue medication” at home (inhalers, EpiPens, seizure rescue medication, hypoglycemia rescue medication, etc.) must also have rescue medication at school. 
Students may self-carry and self-administer certain medications when approved by a physician, parent/guardian, and school nurse.
Students may not carry or maintain any unauthorized or unidentified medication in school or on the school bus.

Public Act No. 19-60 allows students, six years of age or older, to possess and self-apply an over-the-counter sunscreen while in school prior to engaging in any outdoor activity provided a Sunscreen Authorization Form is signed by a student’s parent/guardian and submitted to the school nurse. The sunscreen must be non-aerosol approved by the FDA for over-the-counter use for the purpose of limiting ultraviolet light-induced sun damage.
Students five years of age and younger are not permitted to possess or self-apply sunscreen while in school. If sunscreen is prescribed for a younger student, the healthcare provider must complete an Authorization for the Administration of Medication (must be completed by healthcare provider and parent/guardian) and the sunscreen will be kept in the Health Office.

With parent consent, middle and high school students may receive acetaminophen and/or ibuprofen from the school nurse or designee, as needed, for headache, menstrual discomfort, or discomfort caused by orthodontia. Please complete this form annually and return it to the school nurse:
Authorization for School Nurse to Administer Acetaminophen/Ibuprofen in the Middle and High Schools (2025-2026)

Our District Medical Advisor provides a standing order for common topical preparations to be applied to students at the discretion of the school nurse or designee. The preparations include: aloe vera topical lotion or gel, antibiotic cream or ointment, antiseptic wipes or towelettes, 1% hydrocortisone cream or ointment or Benadryl anti-itch gel, moisturizing hand lotion, sterile eye wash, Vaseline or other lip balm topical preparations. Parents/guardians are to alert the school nurse in writing annually if they do not want these topical preparations applied to their child.

Due to the risk of choking, elementary school students are not permitted to carry their own cough drops. Cough drops may be kept in the Health Office and administered by the school nurse if the student has a doctor's order and signed parent/guardian permission: Authorization for the Administration of Medication (must be completed by healthcare provider and parent/guardian)

Public Act No. 14-176 (“An Act Concerning the Storage and Administration of Epinephrine at Public Schools”) requires the administration of epinephrine as emergency first aid to students experiencing an allergic reaction, even if the student does not have parent/guardian authorization or a prescriber’s order. In the absence of the school nurse, epinephrine may be administered by qualified personnel who have completed the required training.
Substitute Senate Bill No. 1 - Public Act No. 22-80 (“An Act Concerning Childhood Mental and Physical Health Services in Schools”) requires the administration of an opioid antagonist (Narcan, or its equivalent) on an emergency basis, without prior written authorization, to students experiencing opioid-related overdoses. In the absence of the school nurse, opioid antagonists may be administered by qualified personnel who have completed the required training.
Parents/guardians are to alert the school nurse in writing annually if they refuse to have epinephrine and/or an opioid antagonist administered to their student as emergency first aid by the school nurse or, in the nurse’s absence, by qualified personnel.

Students with asthma may require medication at school before physical activity and when their asthma is flaring up. The following should be provided to the school nurse at the beginning of each school year:
Asthma Action Plan completed by the healthcare provider (example: asthma-action-plan-aafa.pdf)

• Current medication authorization: Authorization for the Administration of Medication (must be completed by healthcare provider and parent/guardian)
• Medication(s) in the original container, properly labeled, and not expired. 

Students with diabetes need a comprehensive care plan to manage their diabetes at school. The school nurse will work closely with parents/guardians, the child, and the child’s healthcare provider to develop this plan. The following should be provided to the school nurse at the beginning of each school year:

• Diabetes Medical Management Plan completed by the healthcare provider (example: https://diabetes.org/sites/default/files/2025-07/DMMP-July-31-2025.pdf) 
• Supplies: blood glucose monitor, lancing device or lancets, unexpired blood glucose meter strips, ketone strips, low blood sugar treatment (glucose tabs, juice, candy), insulin syringes, rapid-acting insulin, glucagon or its equivalent, alcohol pads, for CGM users: extra sensors and adhesive, for pump users: charger/batteries, extra infusion sites cartridges, extra adhesive.
• Medication(s) in the original container, properly labeled, and not expired. 

Students with life-threatening allergies must have their personal anaphylaxis rescue medication at school (EpiPen, AUVI-Q, neffy, etc.). Stock epinephrine is intended for anaphylactic emergencies in undiagnosed students, and we are not permitted to send stock epinephrine out on field trips.  The following should be provided to the school nurse at the beginning of each school year:

• Anaphylaxis Emergency Care Plan completed by the healthcare provider (example: Food Allergy & Anaphylaxis Emergency Care Plan - FoodAllergy.org)
• Current medication authorization: Authorization for the Administration of Medication (must be completed by healthcare provider and parent/guardian) 
• Medication in the original container(s), properly labeled, and not expired.

Students with a seizure disorder who require seizure rescue medication at home (Diastat, Valtoco, Nayzilam, etc.) must have their personal seizure rescue medication at school.  The following should be provided to the school nurse at the beginning of each school year:

• Seizure Action Plan completed by the healthcare provider (example: Seizure Action Plan - 2023 - ACC)
• Current medication authorization: Authorization for the Administration of Medication (must be completed by healthcare provider and parent/guardian)
• Medication in the original container(s), properly labeled, and not expired.