Health & Safety

Required Health Forms for All IMS Students

Parents are required to complete two medical forms as part of the enrollment process.

  1. The medical/immunization history form (3 pages, same as the School District of Philadelphia)
  2. The request/consent for administration of medication (1 page, same as the School District of Philadelphia)

 

Immunization Requirements

The following immunizations are required by the Commonwealth of Pennsylvania for enrollment in any private or public school (including all Independence Mission Schools).

Children entering Pre-K, Kindergarten, and 1st Grade must present documented proof that the following immunizations have been received:

  • Diphtheria & Tetanus (4 doses, at least one after the 4th birthday)
  • Pertussis (4 doses, at least one after the 4th birthday)
  • Polio (4 doses)
  • Measles (2 doses, both after the 1st birthday)
  • Rubella (2 doses, both after the 1st birthday)
  • Mumps (2 doses, both after the 1st birthday)
  • Hepatitis B (3 doses of vaccine)
  • Varicella (2 doses, both after the 1st birthday)

Children entering 6th grade must present documented proof that the following immunizations have been received:

  • Diphtheria & Tetanus (4 doses, at least one after the 10th birthday)
  • Pertussis (1 dose, at least one after the 10th birthday)
  • Polio (4 doses)
  • Measles (2 doses, both after the 1st birthday)
  • Rubella (1 dose, after the 1st birthday)
  • Mumps (1 dose, after the 1st birthday)
  • Hepatitis B (3 doses of vaccine)
  • Varicella (2 doses, both after the 1st birthday)
  • Meningococcal (1 dose)

Please inform the school nurse, in writing, when boosters are given.