Kindergarten Health Forms
Welcome to Kindergarten! 
We are happy to see you and would like for you to stay healthy the whole year through. I have included in this information packet required forms, recommended exam forms, and other helpful information. 
All new kindergarteners must have a(n):
·         New Student Health Form
·         Health Update Form
·         Immunization record with proof of booster shots
If you are coming from another school, a records request will be processed so that all previous health care records including immunizations will be sent here.
The State of Wisconsin (statute 252.04) requires children who attend school to be adequately immunized against childhood illnesses. This law requires that an immunization record be given to the District within 15 days of your child starting school. 
Parents may sign a waiver if by personal, religious, or medical reasons they decide that their children should not be immunized. 

Kindergarten Requirements4 DTP/DTaP/DT/Td*     4 Polio*    2 MMR*     3 Hep B 

                                                           2 Varicella (or history of chickenpox)

                *The last of these immunizations must be given after a child’s fourth birthday to be counted. 
Other Recommended Health Exams:
It is also highly recommended that all incoming kindergarteners receive:
  • a complete physical
  • eye examination
  • dental exam  
These forms are attached for your convenience.
School Nurse Hours/Website:
I will be in the District Monday afternoons, all day Tuesday, and all day Thursday to oversee health care in the District. All secretaries are trained to handle first aid and medication administration. Please feel free to stop in if you have any questions or concerns. You may also leave me a voicemail and I’ll return your call as soon as I can. 
You can also find health resources and additional information on the District Website:, click on “District” and then click on “Health Information.”
Holly Bauer, RN BSN
867-2148 Ext. 314
410 East Ann Street, PO Box 580
Weyauwega, WI 54983
Phone: (920) 867-8800
Fax: (920) 867-8815
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