SOUTH BEND COMMUNITY
School Corporation
Requirements
- Medical Forms
- 6th Grade Immunization Requirements
- 12th Grade Immunization Requirements
- Immunization Schedules
- Community Health Resources
Medical Forms
Medications and special diets can be accommodated for your child while at school. Medication policies are discussed in the “Guide for Administration of Medication at School” document below.
In order for your child to receive medication, carry emergency medication, or have a special diet plan while at school, the following forms must be completed and signed by a licensed health care provider. Please give or mail these completed forms to your school nurse.
Guide for Administration of Medication at School (Spanish)
Authorization to Administer Medication (Spanish)
6th Grade Immunization Requirements
6th Grade Immunization Requirements 2024-25
The following are the state required and recommended immunizations needed for entry into the 6th grade. Please provide immunization paperwork to the school nurse or office personnel prior to the first day of school on August 15, 2024.
Minimum Immunization Requirements for 6th Grade:
- 5 doses DTaP
- 4 doses Polio
- 2 doses MMR
- 2 doses Varicella
- 3 doses Hepatitis B
- 2 doses Hepatitis A
- 1 dose MCV4 (Meningococcal)
- 1 dose Tdap (Tetanus, Diphtheria, & Pertussis)
*Note: Some physicians will not give the doses until the child has reached their 11th birthday, so please check when you make your appointment.
Recommended Immunizations:
- Annual Influenza
- HPV (Human Papillomavirus)
- Covid-19
In addition, the CHIRP Consent Form and Parent Consent to Share Medical Information forms can be printed from this site.
The CHIRP Consent Form must be signed in order to allow the school nurse to keep your child’s immunization record as current as possible in the state registry. This ensures that parents and students will have access to immunization information when it might be needed in the future. For example, when required for college, military or job applications.
- CHIRP Consent
The Parent Consent to Share Medical Information Form allows the school nurse to share medical information with other school personnel that need to be informed. If you have any questions about immunizations, or whether you have signed these forms please contact your School Nurse.
- Parent Consent to Share Medical Information
Additional Suggestions and Information:
Immunizations can be obtained from your health care provider or at the St. Joseph County Health Department. St. Joseph County Health Department information and hours can be found (here).
*Thank you for working with us to keep your child healthy! If you have any questions or need a copy of your child’s current immunization record please contact your school nurse*.
12th Grade Immunization Requirements
12th Grade Immunization Requirements 2024-25
The following are the state required and recommended immunizations needed for entry into the 12th grade. Please provide immunization paperwork to the school nurse or office personnel prior to the first day of school on August 15, 2024.
Required Immunizations:
- 5 doses DTaP
- 4 doses Polio
- 2 doses MMR
- 2 doses Varicella
- 3 doses Hepatitis B
- 2 doses Hepatitis A
- 2 doses MCV4 (Meningococcal) (2nd dose is a new requirement for 12th grade age 16 or above)
- 1 dose Tdap
Recommended Immunizations:
- Annual Influenza
- HPV
- 2 MenB (Meningococcal - Required for College)
- Covid-19
In addition, the CHIRP Consent Form and Parent Consent to Share Medical Information forms can be printed from this site.
The CHIRP Consent Form must be signed in order to allow the school nurse to keep your child’s immunization record as current as possible in the state registry. This ensures that parents and students will have access to immunization information when it might be needed in the future. For example, when required for college, military or job applications.
- CHIRP Consent
The Parent Consent to Share Medical Information Form allows the school nurse to share medical information with other school personnel that need to be informed. If you have any questions about immunizations, or whether you have signed these forms please contact your School Nurse.
- Parent Consent to Share Medical Information
Additional Suggestions and Information:
Immunizations can be obtained from your health care provider or at the St. Joseph County Health Department. St. Joseph County Health Department information and hours can be found (here).
*Thank you for working with us to keep your child healthy! If you have any questions or need a copy of your child’s current immunization record please contact your school nurse*.
Immunization Schedules
Indiana Immunization Schedules
Indiana Code sets forth certain requirements for school immunizations. Attached are the requirements and recommended immunization schedules for the 2024-25 school year in every grade level. Please note that SBCSC requires proof of lead screening for pre-K and Kindergarten enrollment.
Parents or guardians must provide proof of immunizations to the school nurse on or before the first day school year.
Contact your health care provider or the St. Joseph County Health Department (SJCHD) to schedule an appointment for these required vaccines. Immunization visits at the SJCHD are currently by appointment only. Call 574-245-6656 to schedule an appointment.
If you need a copy of your child’s immunizations, contact your school nurse.
Community Health Resources
2018-19 School Immunization Requirements_English
2018-19 School Immunization Requirements_Spanish
HPV Information Letter in English
HPV Information Letter in Spanish
Meningococcal Notifications in English & Spanish
National Association of School Psychologists
Reducing Obesity Coalition (ROC)
Authorization to Administer Medication
Self-Administration of Medication
Medical Alert Letter - English
Medical Alert Letter - Spanish