All forms for the 2017-2018 school year are due Friday, July 14, 2017

This page serves as a quick reference to let you know which  screenings and immunizations are required to be on file for your child based on his or her grade level. Please send your documentation and/or questions to the Ancona Registrar, or just drop them off at the front desk.

Please note that hearing and vision screenings conducted by a technician are at offered at Ancona during the fall of each school year. These screenings are available at no cost to families.

New Students 

Note that new students who are starting mid school-year must have all forms on file before their first day of school.

* Hearing and vision screenings are provided by Ancona in the Fall, so students starting in September do not need to undergo hearing and vision screenings before coming to Ancona.  However, new students starting mid school-year must be screened elsewhere before their first day of school.

Preprimary

Kindergarten

1st grade

  • hearing screen (provided by Ancona)

2nd grade

  • vision screen (provided by Ancona)
  • hearing screen (provided by Ancona)
  • dental exam

3rd grade

  • hearing screen (provided by Ancona)

5th grade

6th grade

7th grade

  • show proof of receipt of one dose of Tdap vaccine (containing tetanus, diphtheria, acellular pertussis). Most students may have already received the vaccine and simply need to provide the school with verifying documentation from the family health care provider.
  • students who will be participating in a sport must receive a sports physical examination  
  • Students who are going to Camp (Concordial Language Villages) need a physician to fill out this camp form.

8th grade

  • vision screen (provided by Ancona)
  • show proof of receipt of one dose of Tdap vaccine (containing tetanus, diphtheria, acellular pertussis). Most students may have already received the vaccine and simply need to provide the school with verifying documentation from the family health care provider.
  • students who will be participating in a sport must receive a sports physical examination  

Students receiving special education services 

  • vision screen (provided by Ancona)
  • hearing screen (provided by Ancona)

Student who need to have medications administered at school that are not included in the action plan need to complete the following form

Quick List of Health Forms

Physical Exam Form

Dental Exam Form

Eye Exam Form

Medication Form

Religious Immunization Exemption Form

Students with allergies, asthma, diabetes, seizure disorder or other medical conditions that require medications or accommodations at school: