Immunizations Forms | Notifications

Documentation/Tracking Forms for Immunizations 

Immunization Survey Worksheets are located on the Data Reporting Page

OSAS Pertussis Booster Worksheet for Recording Immunizations  Worksheet to track students who are not yet 11 years old 12/16

2018-19 Immunization Requirements

2018-19 Immunization Requirements for School Attendance Chart NYSDOH (1/2018)

Letters to Parents/Guardians with 2018 immunizations for students by grade

Sample Exemption Letters/Forms

School District Procedures for Implementing Requests for Religious Exemption to Immunization (March 2016) -This memo provides sample guidance to school district officials on how to implement the religious exemption from student immunization requirements. 

Sample Religious Exemption Request Form for Parent/Guardian. Form for parent/guardian to complete when applying for a religious exemption to Public Health Law. 3-22-16

Sample medical exemption forms

Sample Exclusion LettersExclusion Letter for Principal to Send to Parents -Provides a sample which principals can customize to send letters to parents whose children have not met the required immunizations. 

Exclusion Letter for Students with Religious/Medical Exemptions During Communicable Disease Outbreak - Letter to parents/guardians whose child has a Religious or Medical Exemption notifying them that in the case of an outbreak, their child would be excluded for the length of contagion. Ideally this information should be communicated when the exemption is granted. 12/6

Parent Communications Regarding Vaccines

Evidence Shows Vaccines Unrelated To Autism This piece summarizes scientific evidence that refutes any vaccine/autism link and presents some of the current thinking on the causes of autism

MMR Vaccine Does Not Cause Autism: Examine The Evidence Summary of studies that refute any connection between MMR and autism

Updated 6/25/18