Medical Forms
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Please use the form below to authorize the school office to assist with certain medications your student may need during the course of a school day. Please print out the form and deliver it to your student's school office.
Click to download each form:
Immunization
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The following is a list of required immunizations by the state of Mississippi. For additional information, you may visit the Mississippi State Department of Health’s website.
- Diphtheria, Tetanus, Pertussis (DTaP)
- Polio (IPV)
- Hepatitis B
- Measles, Mumps, Rubella (MMR)
- Varicella (chickenpox)
We require all children entering a Mississippi school (any grade) for the first time to have the above listed immunizations. This includes Pre-K 4 year olds–12th grade.
Children entering a Mississippi school after their 7th birthday, who do not meet the above DTaP requirements, will need at least 3 total doses of diphtheria/tetanus containing vaccine (Td). Children 10 years and older should be given Tdap as one of the three diphtheria/tetanus containing vaccines (preferably as the first of the 3 doses). Please refer to the Advisory Committee on Immunizations Practices (ACIP) catch up schedule. If a child receives the 4th dose on or after his/her 4th birthday, the child is not required to receive a 5th dose. Children should be given the final dose in the series at 4 years of age, regardless of the number of previous doses. Parents may only waive the MMR vaccine if a physician can provide a diagnosis of previous infection with measles, mumps, and rubella disease or serologic confirmation of immunity to measles, mumps, and rubella.
Parents may also waive the Varicella vaccine if a physician can provide a diagnosis of a past infection, including a past history of chickenpox or serologic confirmation of immunity to chickenpox.
