Links and Documents

Medical Forms
Link to this section

Medical forms are important to keep updated and on file with our office. If your child has allergies, requires medication, or has any other medical concerns please find the documents below and have them filled out by your child's doctor and submit them to the office. If you have questions about documentation please contact the school or your enrollment specialist.

*Please refer to the Student and Family Handbook - 3.10 Medication and Emergency Care Plan Forms as well as the School Health Manual for more information

Allergies

Forms required on file for children with allergies:

 

Allergy Emergency Care Plan: Form in various languages

 

Epi Pen Administration Form: Form in various languages

Asthma

Forms required if child has asthma:

 

Asthma Emergency Care Plan: Form in various languages

 

Asthma Medication Administration Form: Form in various languages (one medication per form)

Seizures

Forms required if child has a history of seizures:

 

Emergency Care Plan: Form in various languages

 

If your child has a history of seizures and requires anti-seizure medication please contact the school and we can have the nurse provide medication forms and training to staff on site for proper administration. 

Diabetes

Forms required if child has diabetes:


Emergency Care Plan: Form in various languages

Vaccinations

Child Care / PreK

Immunization requirements differ depending on the age of the child when enrolling for child care.

  • 2-3 months: 1 DTaP, 1 Polio, 1 Hep B, 1 Hib
  • 4-5 months: 2 DTaP, 2 Polio, 2 Hep B, 2 Hib
  • 6-14 months: 3 DTaP, 2 Polio, 2 Hep B, 2 Hib
  • 15-17 months: 3 DTaP, 3 Polio, 2 Hep B, 1 MMR (on or after 1st birthday), 1 Hib (on or after 1st birthday)
  • 18 months-4 years: 4 DTaP, 3 Polio, 3 Hep B, 1 MMR (on or after 1st birthday), 1 Hib (on or after 1st birthday- only required for children less than 4 years, 6 months ), 1 Varicella (chickenpox)

TK-12 students

  • Diphtheria, Tetanus, and Pertussis (DTaP, DTP, Tdap, or Td) — 5 doses (4 doses OK if one was given on or after 4th birthday. 3 doses OK if one was given on or after 7th birthday)
  • Polio (OPV or IPV) — 4 doses (3 doses OK if one was given on or after 4th birthday)
  • Hepatitis B — 3 doses (not required for 7th grade entry)
  • Measles, Mumps, and Rubella (MMR) — 2 doses (first dose given on or after 1st birthday) 
  • Varicella (chickenpox) — 2 doses

 

Vaccination requirements:

Preschool Requirements

TK Requirements

Visit CDPH for this information in other languages.

 

Blank vaccination and medical exam form: 

Medical Exam Form

Misc. Medical Forms

General Medication Administration Form: Form in various languages

 

General Emergency Care Plan: Form in various languages

If your child has a medical need that may require emergency action is not listed above please have your doctor fill this out.

Best Interest of the Child Information (Leaves/Vacations)
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Best Interest of the Child (BIC) is how the district refers to time away from school. BIC includes family vacations, leaves, or bereavement. Below you will find information and forms regarding these topics. 

BIC Form

Attendance Policy: EnglishEspañol | 中文

 

BIC Request Form: In English, Spanish, and Chinese

SFUSD Early Education Handbook

SFUSD District Handbook: In various languages

SFUSD Student and Family Handbook

SFUSD District Handbook: In various languages

This page was last updated on September 18, 2023