Student Health Forms
School Health Requirements
Immunizations & Health Forms
Hawaii State Law requires all students to meet physical exam, immunization, and tuberculosis clearance requirements before they may attend a public or private school in Hawaii. Students who do not complete the health requirements by the first day of school may not be allowed to attend school until they are met.
Are Exemptions allowed?
Children may be exempt from immunization requirements for medical or religious reasons, if the appropriate documentation is presented to the school.
Medical exemptions forms must be signed by your child’s healthcare provider.
A Religious exemption form can be submitted to the front office.
No other exemptions are allowed by the State.
Health Requirements
Tuberculosis (TB) Risk Assessment: Must be dated within the last 12 months before the first day of school. (Note: This is only required for new students.)
Physical Examination: A physical exam must be on file, which was completed within 12 months before the first day of school. If the annual physical exam is scheduled after the first day of school, please submit it to the front office.
Immunizations: Immunizations are required for all students (new, returning, and out of state). Required immunizations depend on the age of the child or grade of the student. Students entering the 7th Grade have an additional 3 required immunizations. All immunizations must meet minimum age and interval requirements between vaccine doses.
Beginning July 1, 2020, additional immunizations will be required for students entering 7th grade, and all students entering school in Hawaii for the first time, regardless of age. The updated immunization requirements conform with current national recommendations and reflect what occurs in healthcare provider offices and clinics in Hawaii as standard medical practice.
Here is a link to the updated School Health Requirements effective July 1, 2020.
New Students
All new students to Namahana School, regardless of grade level, must have the following completed by the first day of school.
TB clearance
Annual physical exam
Updated immunizations
Schedule an appointment with your child’s physician to complete the Student Health Record Form 14 & TB assessment forms.
7th Grade Students
All 7th grade students must have the following completed prior to the first day of school:
TB clearance
Annual physical exam
Updated immunizations, including:
Human Papillomavirus (HPV)
Meningococcal Conjugate (MCV)
tetanus-diptheria-peertussis (Tdap)
Schedule an appointment with your child’s physician to complete the Student Health Record Form 14 & TB assessment forms. Please see the Notice of School Health Requirements for more information about our State laws.
Returning Students
All returning students must have a current health and immunization record in their student file. Student Health Record Form 14 can be found in our Resources.
Where to Submit Your Completed Health Forms
Please submit all forms to the front office.
Questions or need more help?
For general questions regarding the health forms please contact the front office at 808-828-0788.
Students who Require Daily or Emergency Medications
Request to Store and Administer Medications (SH36 Form)
Required prior to the start of school for all non-diabetes medications, including asthma, allergies, and seizure-related emergency medications. No medications will be accepted or administered without this signed authorization.
Volunteer Authorization to Administer Epinephrine and Glucagon
Allows educated staff members to administer Epinephrine or Glucagon in emergencies when paired with a completed SH36.
Student Medication Self-Administration and Carry Authorization
Allows students to self-carry and self-administer inhalers, epinephrine, or glucagon (if not already authorized on SH36), and may prompt a consulting nurse to develop an Emergency Action Plan.