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Nurse's Corner

Wapsie Valley Parents,

Please refer to the forms below to find out the requirements for the 2019-2020 school year:

Certificate of Dental Screening: Iowa law now requires that any child who is entering 9th Grade, or is an out-of-state transfer student, must provide the school with proof of a dental check-up.

Physical Form: All student-athletes in Grades 7-12 is required to have a physical.

Heads UP Concussion Form:  All students in Grades 7-12 is required to have a concussion form filled out and signed by the student and the parent or guardian.

Health and Injury Information Card and Consent For Medical Treatment:  Form must be filled out by every student-athlete.


Requirements per grade are listed below:

                 7th Grade Students:

                                                 Immunizations: All students enrolling in 7th grade need to have an updated Tdap 

                                                 vaccine. This will require a one-time booster dose of tetanus, diphtheria, and acellular

                                                 pertussis-containing vaccine PRIOR to starting the 7th grade. All students enrolling in

                                                 7th grade will also need proof of one dose of meningococcal (A, C, W, Y) vaccine. 

                                                 Concussion Form: This is a requirement for ALL students. This form needs to be

                                                 signed by parent or guardian and student.

                              7th Grade Student Athletes: 

                                               Physical or Athletic Pre-Participation Physical Examination: This form needs to be

                                               filled out by the student’s primary care doctor if planning to participate in extracurricular

                                               activities PRIOR to participation. (Tdap can be done at time of athletic physical.)

                                               Health and Injury Information Card and Consent for Medical Treatment Form: This

                                               form needs to be filled out and signed by the parent or guardian of the student athlete.


                9th Grade Students:

                                               Certificate of Dental Screening: Iowa law now requires that any child who is entering

                                               9th Grade, or is an out-of-state transfer student, must provide the school with proof of a

                                               dental check-up.

                                 Concussion Form: This is a requirement for ALL students. This form needs to be

                                 signed by the parent or guardian and student.

                                Physical or Athletic Pre-Participation Physical Examination: This is a requirement

                                for all incoming 9th graders. This form needs to be filled out by the student’s primary

                                care doctor. Please turn in to the school nurse.

                                Immunization Record: If the student’s immunization record has been updated, this

                                record also needs to be submitted to the school.

               9th Grade Student Athletes:

                                ‚ÄčHealth and Injury Information Card and Consent for Medical Treatment Form:

                                This form needs to be filled out and signed by the parent or guardian of the student athlete.


    8th, 10th, & 11th Grade Students:

                                Concussion Form: This is a requirement for ALL students. This form needs to be

                                signed by the parent or guardian and student.

   8th, 10th, & 11th Grade Student Athletes:

                                Physical or Athletic Pre-Participation Physical Examination: This form needs

                                to be filled out by the student’s primary care doctor if planning to participate in

                                extracurricular activities PRIOR to participation.

                                Health and Injury Information Card and Consent for Medical Treatment Form:

                                This form needs to be filled out and signed by the parent or guardian of the student athlete.


      12th Grade Students:

                                             Immunizations: All students enrolling in 12th grade and born after September 15,

                                             1999, will need proof of two doses of meningococcal (A, C, W, Y) vaccine; or 1

                                              dose if received when the student was 16 years of age or older.

                                Concussion Form: This is a requirement for ALL students. This form needs to be

                                 signed by the parent or guardian and student. 

       12th Grade Student Athletes:

                                Physical or Athletic Pre-Participation Physical Examination: This form needs to

                                 be filled out by the student’s primary care doctor if planning to participate in

                                 extracurricular activities PRIOR to participation.

                                 Health and Injury Information Card and Consent for Medical Treatment Form:

                                 This form needs to be filled out and signed by the parent or guardian of the student

                                 athlete.