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Preschool & Family Center

Ann Arbor Public Schools

Preschool Health Requirements

Dear Families,

All students participating in preschool with Ann Arbor Public Schools are expected to provide us with the following medical documentation:

Before your child's first day of school:

Your child is required to have at least one of each type of required vaccination before starting school and must be up to date on all vaccinations within 120 days of the child's first day of school. Alternatively, you can provide the school with a signed waiver from the Washtenaw County Health Department exempting them from vaccination requirements. The following vaccinations are required for preschool:

4 doses of DTAP (Diptheria, Tetanus, and Pertussis)

4 doses of PCV (Pneumococcal Conjugate)

3 doses of Hib (H. Influenzae type b)

3 doses of Hep B (Hepatitis B)

3 doses of Polio

1 dose of MMR (Measles, Mumps, and Rubella)

1 dose of Varicella (Chickenpox)

Within 30 days of your child's first day of school:

A physical examination (health appraisal). The exam must have occurred within the past 12 months.

A complete physical exam should include the following:

Blood Pressure results

Height and Weight measurements

Hearing Screening

Vision Screening

Lead blood test results (blood test must have occurred after age 2)

Hemoglobin/Hematocrit blood test results (blood test must be within last 12 months)

Each family will also complete a full Health History, Nutritional Assessment, TB screen, and Lead Screening at the time of application. These forms can be found below.

If any above components were not performed with your child's last physical they may need to be completed seperately.

Within 90 days of your student's first day of school:

A dental examination. The exam must have occurred within the past 12 months.

Preschool Physical Exam Form

This physical exam form is provided by the program to parents to use. It is not required that you provide this specific form. Any valid health appraisal or physical exam form is acceptable.

HSPHYSICAL.pdf 168.47 KB (Last Modified on December 15, 2021)

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Preschool Dental Exam Form

This dental exam form is provided by the program to parents to use. It is not required that you provide this specific form. Any valid dental exam form is acceptable.

PreschoolOralHealthPrintVersion.pdf 444.74 KB (Last Modified on December 15, 2021)

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Preschool Nutritional Assessment

This form is completed by the student's parent or guardian at the time the application is submitted. Per our funding requirements, all students are expected to complete a Nutritional Assessment within 30 days of the first day of school.

NUTRITION Assessment updated.pdf 327.61 KB (Last Modified on December 15, 2021)

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Preschool Health History Form

This form is completed by the student's parent or guardian at the time the application is submitted. Per our funding requirements, all students are expected to complete a Health History within 30 days of the first day of school.

HEALTH HISTORY FILLABLE.PDF 219.9 KB (Last Modified on December 15, 2021)

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Tuberculosis/Lead Screening Form

This form is completed by the student's parent or guardian at the time the application is submitted. Per our funding requirements, all students are expected to complete a TB screen and Lead screen within 90 days of the first day of school.

Lead TB fillable.pdf 260.88 KB (Last Modified on December 15, 2021)

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Allergy Action Plan (For students with severe allergies)

This form is for students who have severe allergies that require them to keep emergency medications, such as an EpiPen, at school. The form is complete annually by your child's physican. This form is provided for your convenience. Any valid Allergy Action Plan may be provided to the school.

Allergy Anaphylaxis-EmergencyPlan.pdf 1.67 MB (Last Modified on December 15, 2021)

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Asthma Action Plan (For students with Asthma)

This form is for students who have Asthma which requires them to keep emergency medications, such as an Albuterol rescue inhaler, at school. The form is complete annually by your child's physican. This form is provided for your convenience. Any valid Asthma Action Plan may be provided to the school.

Asthma Action Plan A 2019 .pdf 463.51 KB (Last Modified on December 15, 2021)

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Medication Authorization Form (For students who need medication at school)

This form is for students who have health conditionas that require them to keep emergency medications, such as an EpiPen or Albutrol rescue inhaler, at school. The form is complete annually. This form is provided for your convenience. Any valid Medication Authorization may be provided to the school.

Medication-Authorization-Form.pdf 163.01 KB (Last Modified on December 15, 2021)

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Food Substitution Form (for students with medical food restrictions)

This form is for students who have restrictions regarding the food that they can eat for medical reasons, such as an allergic reaction. The form is complete annually by your child's physican. This form is provided for your convenience. Any valid letter or form may be provided to the school.

Food_Accommodating Children Needs.pdf 174.62 KB (Last Modified on December 15, 2021)

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ANN ARBOR PUBLIC SCHOOLS STATEMENT OF NON-DISCRIMINATION: No person shall be excluded from participation in, be denied the benefits of, or be subjected to discrimination in any educational program or activity available in any school on the basis of race, color, sex, religion, creed, political belief, age, national origin, linguistic and language differences, sexual orientation, gender, gender identity, gender expression, socioeconomic status, height, weight, marital or familial status, disability or veteran status. The following person has been designated to handle inquiries regarding the nondiscrimination policies: The Executive Director of Human Resources, 2555 S. State Street, Ann Arbor, MI 48104 (734) 994-9444.

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