School Requirements, 2016-2017
Watch the webinar or view the slides that describe the changes for the 2016-2017 school year.
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Instructions for Schools
- Full booklet: Wisconsin School Immunization Requirements, 2016-2017 (PDF, 3.7 MB)
- Letter to schools (PDF, 30 KB)
- Timeline and flowchart of actions required by schools (PDF, 279 KB)
- Immunization law clarification (PDF, 205 KB)
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Immunization requirements - English (PDF, 12 KB) - Spanish (PDF, 12 KB) - Hmong (PDF, 12 KB) - Somali (PDF, 12 KB)
Forms, Reports, and Letters
- Student immunization record - English (PDF, 150 KB) - Spanish (PDF, 96 KB) - Hmong (PDF, 94 KB)
- Legal notice -English, editable (MS Word, 43 KB) - English (PDF, 89 KB) - Spanish (PDF, 95 KB) - Hmong (PDF, 117 KB) - Somali (PDF, 166 KB)
- Notice of exclusion - English (PDF, 66 KB) - Spanish (PDF, 10 KB) - Hmong (PDF, 71 KB) - Somali (PDF, 67 KB)
- School Report to Local Health Department (PDF, 766 KB)
- Local Health Department contact information
- Search for your school's DPI LEA code and school code: public schools by district | public schools | private schools
- Noncompliance Roster (PDF, 32 KB)
- School Report to District Attorney [for schools not subject to the Family Educational Rights and Privacy Act (FERPA)] (PDF, 42 KB)
- 90th day letter - for students "in process" - English (PDF, 63 KB) - Spanish (PDF, 10 KB) - Hmong (PDF, 11 KB) - Somali (PDF, 64 KB)
- 90th day letter - for students who are not compliant - English (PDF, 63 KB) - Spanish (PDF, 10 KB) - Hmong (PDF, 11 KB) - Somali (PDF, 65 KB)
Compliance results from previous school year
Educational materials for parents
- Tdap fact sheet for parents - English (PDF, 37 KB) - Spanish (PDF, 68 KB) - Hmong (PDF, 70 KB)
- Vaccines recommended at ages 11-12: What parents should know - English (PDF, 322 KB) - Spanish (PDF, 320 KB) - Hmong (PDF, 323 KB)
Day Care Requirements
- Day care assessment results, 2015 (PDF, 166 KB)
- Day care - Immunization record (PDF, 553 KB)
- Day care - Immunization record (Spanish) (PDF, 468 KB)
Additional Resources
- Chapter DHS 144 - Immunization of students
- Wisconsin Statute 252.04
- History of Wisconsin's student immunization law
- College students and meningococcal disease
- Authorization to receive Tetanus, diphtheria, acellular pertussis (Tdap), Varicella, Meningococcal Conjugate (MCV4) or Human Papilloma Virus (HPV) vaccines - English (PDF, 34 KB) - Spanish (PDF, 130 KB) - Hmong (PDF, 29 KB)
- School based clinic consent - Tdap only - English (PDF, 30 KB) - Spanish (PDF, 91 KB) - Hmong (PDF, 33 KB)
- School based clinic consent - Tdap/Varicella - English (PDF, 34 KB) - Spanish (PDF, 97 KB) - Hmong (PDF, 28 KB)
Contacts
Last Revised: September 19, 2016
