Comprehensive Health Screening for Grades TK-1

  • The parent/guardian of a student in kindergarten or first grade shall submit to the Superintendent or designee a certification form developed by the California Department of Health Care Services (DHCS) and signed by the student's health examiner certifying that the student has completed a comprehensive health screening within 18 months prior to entry into first grade or within 90 days thereafter. (Health and Safety Code 124040, 124085)

    The State of California requires the California State Required Form to be signed by the Physician. If a physician prefers to use an office form that they have created, the following must be followed:

    1. Student Identifying information must be filled out at the top of the  California State Required Form

    2. The physician form must be attached to the California State Required Form and include student identifying information.

    3.) The Physician form must include all required information that would otherwise be included on the California State Required Form. Including the office stamp of the physician office and the signature/certified electronic signature of the physician.

     Click here to access the Comprehensive Health Screening Form


    Frequently asked questions about First Grade Health Examination Requirements and Procedures for provider and school personnel can be found in the CHDP School Handbook.