Health Documentation

  • Immunization Requirements:

    Iowa State Code and Clear Creek Amana Community School District policy requires that any student enrolled in school must have proof of immunization status being up to date. This includes the Tdap requirement effective August 2013, which states “All students entering 7th grade to have had a one-time booster dose of tetanus, diphtheria, and acellular pertussis-containing vaccine (Tdap), if born on or after September 15, 2000”.

    All students entering, advancing or transferring into 7th grade and born after September 15, 2004, will need proof of one dose of meningococcal conjugate vaccine (MenACWY).  All students entering, advancing, or transferring into 12th grade, will need proof of two doses of meningococcal (A,C,W,Y) vaccine (1 dose received on or after 16 years of age); or 1 dose if received when the student was 16 years of age or older.

    General Required Health Forms:

    Kindergarten

    • Iowa Certificate of Immunizations to be completed by a healthcare provider or Iowa Immunization Exemption Certificate signed by a healthcare provider or Religious Immunization Exemption Form to be notorized
    • Physical Health Form
    • Iowa Dental Screening Certificate
    • Blood lead Screen
    • Vision Screening Form

    3rd Grade: 

    • Vision Screening Form

    7th Grade: 

    • Certificate of Immunization completed by a healthcare provider to include boosters of the Tdap and Meningitis vaccines. Iowa law requires boosters before the first day of school.

    9th Grade: 

    • Iowa Dental Screening Certificate

    12th Grade: 

    • Certificate of Immunization completed by a healthcare provider to include booster of Meningitis vaccine. Iowa law requires boosters before the first day of school.

FORMS