State law (Ref. Code of Virginia §22.1-270) requires that your child is immunized and receives a comprehensive physical examination before entering public kindergarten or elementary school. The parent or guardian completes this page (Part I) of the form. The Medical Provider completes Part II and Part III of the form. This form must be completed no earlier than one year before your child’s entry into school.
For your convenience, we've included a link to the form.