Health Entrance Requirements
Health Entrance Requirements/Physical Examination Requirements
State of Connecticut Health Assessment Form ("BLUE FORM")
Physical examinations are required for the following students:
A complete physical is required within 12 months of the first day of school. The school nurse must have the completed "blue" physical form on file prior to your child's first day of school. The blue State of Connecticut Health Assessment form (see link above) must be completed by your child's physician with all required immunization dates noted. The front of this form is to be completed by the students' parent or legal guardian.
Students presently in Grade 6 entering Grade 7 AND
Students presently in Grade 10 entering Grade 11
The State of Connecticut Department of Education and the State of Connecticut Department of Public Healthrequire a complete State of Connecticut Health Assessment preformed for each child prior to entering Kindergarten, grade 7 and 11, as well as required immunizations for each of these grades.
A complete physical examination, recorded on the Blue State of Connecticut Health Assessment Record form, is required to have been completed within 12 months during your child’s 6th and 10th grade school year. The school nurse must have received the completed "blue" physical form prior to your child's last day of 6th and 10th grade.
Please note the "blue" State of Connecticut Health Assessment form must be completed by your child's physician with all items marked with an *asterisk performed at the time of the physical examination and include but not limited to HCT/HGB. Immunization requirements for each grade level are also to be recorded by your physician on the “blue” State of Connecticut Health Assessment form. The front of this form is to be completed by the students' parent or legal guardian.
Students who do not meet the state requirement will not be allowed to attend the first day of school for the 7th or 11th grade.
Students registering to attend Simsbury schools from out-of-state or out-of-country
A physical exam (by a United States Physician) must be performed within twelve months of entry to the Simsbury Public Schools. The physical must meet all the requirements of the Connecticut State Law and all the * items listed on the "blue" State of Connecticut Health Assessment record. The State of CT Immunization Requirements (see link at top of page) must be current for the student to enter school.
Students Grades 9 to 12
Simsbury Board of Education requires every student trying out and participating on a school sport team must submit a completed "blue" physical examination form to the school nurse every 12 months. The State of Connecticut Health Assessment Record is now the Sports Physical form as well. The sports physical is valid for twelve months.
It is advised to make your doctor's appointment early in the year so that requirements are completed by the first day of school. Immunization requirements are subject to change in accordance to State laws. Consult your child's physician at time of visit.
If you are financially unable to meet these requirements and your child is on the free/reduced lunch program, please contact the Director of Health Services. The State of Connecticut HUSKY Plan offers a comprehensive health care benefit package for Connecticut children up to age 19. Depending on your family's income, there may be no cost to you. Call 1-877-CT HUSKY for more information.
For the current school year
The CT Health Assessment form must be on file by the last day of your child's 6th or 10th grade school year, but no later than the first day of school when your child enters, seventh or eleventh grade. Parents and students are advised that they can make an appointment with the Director of Health Services or their school nurse to discuss issues they may have about the health examinations. If after this discussion the health assessment is not complete, your child will not be allowed to be enrolled until all requirements are met. This requirement includes all children new to Connecticut schools. Thank you for your cooperation in this important matter.
You are urged to schedule a doctor's appointment well in advance of the June 1 deadline.
Please call the nurse at your school with any questions or concerns.
It is advised to keep a copy of your child's physical form for your records!