HEALTH ASSESSMENT "BLUE FORM" STATE OF CT MANDATED FOR TENTH GRADE

Connecticut State Law requires that in order to attend school, each student in the 10th grade is mandated to have a current physical evaluation on file in the health office. The physical must be in accordance with the guidelines set forth by the CT State Department of Education. The most up-to-date “blue form” or Health Assessment Record can be found at the following web address: 

 portal.ct.gov/-/media/SDE/School-Nursing/Forms/HAR3.pdf 

It is important to note that this is the most recent version of the “blue form” issued from the state and meets all of the current criteria including an oral health screening. The physical may be dated after January 1st of the student's 9th grade year or during the 10th grade year in order to qualify and consider the student in compliance.  All physicals are requested to be received by the end of April or provide a scheduled date for the physical. Please note that this is the last mandated health physical by the State of Connecticut in order for your student to participate in public education. Attendance in school could be restricted without proper documentation. 

For example: A 2025-26 9th grader's physical can be submitted with a physical exam date after January 1, 2025 until April 30, 2026.