REQUIRED HEALTH FORMS FOR ENTRY INTO SKIP PRESCHOOL:

  • PROOF OF A PHYSICAL EXAM, SIGNED BY THE HEALTHCARE PROVIDER WITHIN THE LAST 12 MONTHS
  • PROOF OF LEAD SCREENING RESULTS READ BY THE HEALTH CARE PROVIDER
  • HEALTH HISTORY FORM
  • PROOF OF IMMUNIZATION AS FOLLOWS:
    • 4 doses of DTaP (diphtheria, tetanus, pertussis) vaccine
    • 3 doses of Hepatitis B vaccine
    • 3 doses of Hib (Haemophilus influenzae type b) vaccine
    • 1 dose of MMR (measles, mumps, rubella) vaccine
    • 4 doses of PCV (Pneumococcal Conjugate vaccine) *not routinely given to healthy children 5 years of age and older.
    • 3 doses of Polio vaccine
    • 1 dose of Varicella (chickenpox) vaccine

RI STATE PHYSICAL FORM your health care provider may use a different style of form which is acceptable.

Why test for lead?

What are the Health Effects of Lead?

Lead can affect almost every organ and system in your body. Children six years old and younger are most susceptible to the effects of lead.

Children

Even low levels of lead in the blood of children can result in:

  • Behavior and learning problems
  • Lower IQ and Hyperactivity
  • Slowed growth
  • Hearing Problems
  • Anemia
lead screening form.pdf

LEAD SCREENING FORM

South Kingstown School Department Medication Authorization Form and Medication Administration policy.

Copy of Authorization for Prescription & Non-Prescription Medications to be Taken During School Hours web

South Kingstown Emergency plan for Insect and Food Allergies to be completed by the healthcare provider and signed by provider and the parent or guardian


BEESTING FORM/FOOD ALLERGY.doc