Adopted: April 2025
Revised:
Download 501.5.2P - Student Immunization Form
1. Purpose
Regulation 501.5AR, Student Immunizations requires that all students receive the proper immunizations as mandated by law, or provide appropriate exemption documentation, to ensure the health and safety of all students. The purpose of this Student Immunization Compliance Procedure is to describe the process for student immunization compliance, including exclusion, when a student has not met the requirements.
2. Student Immunization Compliance Requirements
2.1 To remain in attendance in a District 196 school (including early childhood education programs), the adult student or the student's parent or guardian must submit to the school nurse or designee, one of the following required proof of immunization or exemption statements:
2.1.1 an immunization statement affirming the month, day, and year that the student received all immunizations required by law, consistent with medically acceptable standards; or
2.1.2 an immunization statement affirming the month, day, and year that the student received at least one dose of each immunization required by law and a schedule from the provider for the completion of the immunizations; or
2.1.3 a signed medical statement affirming that the immunization of the student is contraindicated for medical reasons or that laboratory confirmation of the presence of adequate immunity exists; or
2.1.4 a notarized statement, indicating that the student has not been immunized because of the conscientiously held beliefs of the parent, guardian or adult student.
3. Procedure for Ensuring Compliance
3.1 It is the responsibility of the parent/guardian or adult student to provide updated immunization or exemption information to their school nurse to meet compliance requirements.
3.2 Nurses will routinely review student health records to determine whether the required information for state mandated immunizations has been provided by the parent/guardian or adult student and whether students meet compliance requirements.
3.3 Nurses will routinely notify the parent/guardian or adult student when there is insufficient immunization information on record to meet compliance requirements.
3.4 Nurses will reference the district’s annual immunization exclusion timeline and send a first letter notifying the parent/guardian of the student’s noncompliance, along with the most recent immunization information on file at school.
3.5 Nurses will provide information to assist the parent/guardian or adult student in making informed decisions regarding immunizations and provide resources to improve access to immunizations when needed.
3.6 Nurses will notify the parent/guardian or adult student of actions to take to meet immunization requirements and of the consequence for failure to provide required documentation regarding immunizations within the defined time period.
3.7 Nurses will make at least three documented communication attempts to the parent/guardian, including the first letter described in Section 3.4 above, prior to proceeding with the action described in Section 3.8 below.
3.8 Nurses will reference the annual immunization exclusion timeline and send a second letter notifying the parent/guardian of the student’s impending exclusion from school if immunization compliance requirements are not met.
3.9 The District will reference the annual immunization exclusion timeline and send a third and final letter notifying the parent/guardian of the student’s imminent exclusion from school.
3.10 Schools will not permit a student to attend school or in-person activities when immunization compliance requirements have not been met by the exclusion deadline. Absences due to immunization exclusion will be marked as unexcused.
3.11 If an excluded student arrives at school on or after the exclusion deadline, despite not meeting requirements, they will not be permitted to attend class and the parent/guardian will be required to immediately pick them up from school if the student is not able to transport themselves.
3.12 Students may return to school when documentation of required immunizations or exemption to meet compliance requirements is received by the school.