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Medical Forms

- Admissions

ALL students are required to get their medical paperwork in- either email it to Nurse Lori at [email protected] or drop it off at the nurse's office- before the First Day of School. All forms can be found in the links below.

Thank you,
Nurse Lori

The TCCBED and Archdiocese of Galveston/Houston office requires that all students
have a Pre-Participation Physical Evaluation, Student Emergency Information Card & TB Questionnaire along with an up-to-date Immunization Record on file:

Pre-Participation Physical Evaluation
Student Emergency Information Card
TB Questionnaire

If your student has any condition that requires intermittent or ongoing treatment, please complete the corresponding form from the list below:

Medication Permission
Diabetes Action Plan
Food & Life-Threatening Allergies Action Plan
General Illness Action Plan
Student Seizures Form

All medical FORMS must be completed and returned to the Nurse before the first day of school. If you have any questions, please contact our School Nurse at [email protected]

Immunization Requirements:
3 and 4 year olds:
- Polio – 3 doses
- DTP/DTaP – 4 doses
- MMR – 1 dose on or after 1^st birthday
- HIB – 1 dose on or after 15 months unless a primary series and booster was completed prior to, or at, 15 months of age.
- Hepatitis A – 2 doses
- PCV7 - 2 doses
*It is recommended that DPT/Polio and 2^nd MMR be given as soon as possible after the 4^th birthday. They are required by the 5^th birthday. Varicella – 1 dose if born after September 2, 1994.

5 and 6 year olds:
- Polio – 3 doses with one on or after the 4^th birthday.
- DTP/DTaP/TD – 4 doses with one on or after the 4^th birthday.
- MMR – 2 doses – first given on or after the 1^st birthday and second given no sooner than 28 days from the first doses.
- HEPITITIS B – 3 doses
- Varicella – 1 dose
7 Year olds:
- Polio – 3 doses with one on or after the 4^th birthday.
- DTP/DTaP/TD – 3 doses any combination with one received on or after the fourth birthday.
- MMR – 2 doses – first dose given on or after the first birthday and second dose no sooner than 28 days from the first dose.
- HEPITITIS B – 3 doses if born after September 2, 1992. It is recommended for all students.
- Varicella – 1 dose if born after September 2, 1994.
Middle School requirements are:
- DTP/DTaP – 3 doses (any combination) with one dose on or after the fourth birthday and within the last ten years.
- Polio – 3 doses with one dose after the fourth birthday.
- MMR – 1 dose on or after the first birthday and a second dose by the 12^th birthday if born between September 1, 1978, and before September 1, 1991.
- Hepatitis B – 3 doses.
- Varicella – 1 dose if born before September 2, 1994.

Medical Forms

ALL students are required to get their medical paperwork in- either email it to Nurse Lori at [email protected] or drop it off at the nurse's office- before the First Day of School. All forms can be found in the links below. Thank you, Nurse Lori

Immunization Requirements:

3 and 4 year olds:

5 and 6 year olds:

7 Year olds:

Middle School requirements are:

ALL students are required to get their medical paperwork in- either email it to Nurse Lori at [email protected] or drop it off at the nurse's office- before the First Day of School. All forms can be found in the links below.

Thank you,
Nurse Lori