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Get 7th Grade Physical Form

Ician (please print) Summary of the School Immunization Rules and Regulations Students from Kindergarten through 12th Grade, including all transfer students from outside the State of Nebraska and any foreign students. 3 doses of DTaP, DTP, DT, or Td vaccine, one given on or after the 4th birthday, 3 doses of Polio vaccine, 3 doses of pediatric Hepatitis B vaccine or 2 doses of adolescent vaccine if student is 11-15 years of age. 2 doses of MMR or MMRV vaccine, given on or after 12 months of ag.

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