• Physical Exam and Immunization Requirements

    CT State law requires complete primary immunizations and a health assessment to be completed prior to initial school entrance (C.G.S. Secs. 10-204a and 10-206).  An immunization update and additional health assessments are required in 6th or 7th grade.  Salem School District requires this update prior to entry into 7th grade.

    Please click the appropriate link to view the State of Connecticut's required Health Assessment Record.  Both forms have two parts. Part I is to be completed by a parent prior to being examined. Part II is to be completed by a health care provider.

    Health Assessment Form – To be printed on BLUE paper (accepted for ALL grades)
    Early Childhood Assessment Form – To be printed on YELLOW paper (birth to 5)
    Click here for the DPH Required 2023-24 immunizations per grade level and new entry.
     Sport Physical Requirements
    A blue physical form is required prior to your child participating in the sport program.  Sport physicals are valid for thirteen months.  Bridge notes are not accepted.
    Other Health Forms: