Health Forms

The District of Columbia (DC) requires annual health certificates and assessments for students attending schools in DC, including our school, that must be submitted before your child's first day. Learn more below.

All students at our school need to complete the forms and assessments annually, even if you don't live in DC. We need to collect the required forms before your child can start school.

The charts below explains the forms, requirements, due dates, and frequency for each requirement. There are additional requirements for students with known medical needs.

Required for All Students
Form Name Description Due Date Frequency
DC Universal Health Certificate Health Certificate that has sections that must be completed by the parent/guardian and a health care provider and will include immunization records.
■ Physical exam must be dated within 365 days prior to the first day of school.
■ For student athletes the certificate expires 365 days from the date of the exam.
■ Vaccinations must be up to date with the school immunization requirements.
Before your child's first day of school. Annually
DC Oral Health Assessment Certificate that has sections that must be completed by the parent/guardian and an oral health care provider. Before your child's first day of school. Annually

BISW Emergency Medical Form

The school's emergency contact and medical information form that must be completed by the parent/guardian. Before your child's first day of school. Annually
DC HPV Opt Out Certificate The parent or guardian of students enrolling in Years 7-13are required to submit certification that the student has either received the Human Papillomavirus (HPV) vaccine or signed the opt-out form. Before your child's first day of school in Y7-13. One-time

Parents or guardians of students with known medical needs should also complete the required forms below, based on their specific needs.

Required for Students with Medical Needs
Form Name Description Due Date Frequency
Authorization for Medication Form Completed by completed by the parent/guardian and a health care provider for all medications to be administered by the school. Before your child's first day of school or before the medication can be administered. Annually for existing medication needs; at the time of diagnosis for new or temporary medications.
Self-Administration of Medication Form Completed by the parent or guardian and a health care provider for students who will carry and self-administer medication (inhaler, EpiPen, diabetic supplies, etc.). Before your child's first day of school or before the medication can be administered. Annually for existing medication needs; at the time of diagnosis for new medications.
Action Plan for Asthma Completed by the parent or guardian and a health care provider outlining the student's asthma action plan. Before your child's first day of school. Annually
Action Plan for Anaphylaxis Completed by the parent or guardian and a health care provider outlining the student's anaphylaxis action plan. Before your child's first day of school. Annually

Seizure Questionnaire

Action Plan for Seizures

Completed by the parent or guardian and a health care provider outlining the student's seizure action plan. Before your child's first day of school. Annually