IMMUNIZATION RECORD REQUIREMENTS FOR ENROLLMENT

Effective September 1, 2003

New (first time) Students, Including Home School Students:

At the time of enrollment, all students enrolling for the first time in a public or private school must present proof of their complete or on-schedule immunization status for all State mandated immunizations. There is no grace period.

Students who are incomplete, but who are on the recommended immunization schedule must complete the required immunizations as rapidly as medically possible.

Transfer Students Only – 30 Day Provisional Enrollment: Parents must sign a request for records.

The State of Texas allows a maximum of 30 days for immunization records to be transferred when a student transfers into any Texas school from any other, private or public school.

The school can request records from previous schools, but it is not the school’s responsibility to assure receipt of the requested transfer records within the thirty day grace period. If the record does not arrive within the 30 day grace period, the student is required to provide the school with proof of their complete or on-schedule immunization status for all State mandated immunizations.

Students entering from Home Schools do not qualify for the 30 day grace period.

End of 30 day grace period for this qualifying student ____________________

All Students Entering From a Foreign Country:

At the time of enrollment, any student enrolling in a Lewisville ISD school from any foreign country regardless of the student’s citizenship, nationality, or country of origin, must provide verification of their tuberculosis status as determined within the previous three months by test result or physician evaluation.

Verification of Immunizations:

Any official document or proof of immunization is acceptable; medical certificate or record, insurance record, invoice or receipt, health department record, or government documents.

To be acceptable, the month and year of each immunization should be on the record.

Matter of Conscience/Religious Conflict: Requires an affidavit signed by the legal parent or guardian. The required form must be obtained from the State. This exemption does not apply in times of emergency or vaccine preventable outbreak.

Medical Contraindications: Requires a certificate signed by a physician licensed to practice in the United States, in which it is stated that, in the physician’s opinion, the required immunization would be injurious to the health and well-being of the applicant or any member of the family or household. Unless a lifelong condition is specified, the certificate is valid for only one year. The certificate must specify which immunizations are covered by the exemption.

Parent receives section above the dotted line. School retains signed section below the line.

Name of Student _______________________________ Date of Birth ___________ Grade __________ Homeroom ______________

I have received a copy of the Immunization Record Requirements for the Lewisville Independent School District. Date ___________

Parent/Guardian Signature ________________________________ For transfer student only: End of 30 day Grace Period __________