State Of Virginia Minimum Health Requirements Prior To School Entry

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***PLEASE USE THIS IN CONJUNCTION WITH THE SCHOOL ENTRANCE HEALTH FORM***
Minimum Health Requirements Prior to School Entry (Form MCH)*
By law in the State of Virginia, any child may be prevented from entering school if a physical examination and/or
immunizations are not complete.
1. Health History: Part I of MCH* Completed by parent/guardian.
2. Immunizations: Part II of MCH* Immunizations do not have to be recorded on page 2 if they are recorded on
another form with the name of the vaccine and the date it was administered. Immunization record must be signed by
doctor, RN or health department official. Minimum requirements are listed below.
3. Physical Examination: Part III of MCH* Form completed no more than 12 months prior to entry into elementary
school. May accept physical examination from a doctor or nurse practitioner on form other than VA (MCH) if the
scope of the exam is the same as the VA required one. Per VDOE, scope of out-of-state physical exams means it
must include at a minimum: 1) the visit was a well child visit 2) a review of systems occurred 3) areas of concern
and any medically necessary restrictions are noted and 4) signature of healthcare provider and date of exam.
Immunization
Minimum number required
th
DTaP, DTP, DT or Tdap
3 w/ 1 dose on or after 4th birthday. If 6 doses before 4
birthday
no additional doses needed
th
th
th
th
Tdap Booster
Required prior to entry into 6
, 7
, 8
or 9
grade if >5 years since
last tetanus
Polio (OPV or IPV)
3 w/ 1 dose on or after 4th birthday
st
rd
Hepatitis B
3 with at least 4 month spacing between 1
and 3
doses
Measles, Mumps, Rubella
2 MMRs or 2 Measles and 1 each of Mumps & Rubella
(MMR)**
Second MMR may be administered at pre-K physical.
Varicella (chicken pox)**
1 if born on or after 1/1/97; none required if history of disease
reported
* MCH is the Commonwealth of Virginia School Health Entrance Form; current version is
MCH-213 F
st
** First dose must be on or after 1
birthday
Exemptions to above requirements:
1. Family objects to immunizations and/or physical exam for religious reasons.
2. Family is homeless.
3. Student is medically exempt from immunizations – must have signature from physician stating
reason for medical exemption and what time, if any, the exemption will be removed.
4. Student has had at least 1 of shot of each series and the minimum interval between shots has not
been reached. Family must present a schedule for completion of all required series (catch-up).

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