Incoming 6th Grader Health Forms

Section 1 - Required Immunizations

Welcome new Leota Middle Parents!

Please take a moment to review the following document on the immunizations that are necessary for students in the Northshore School District:

Required Immunizations for School Year 2021-2022PDF download (English and Spanish)

Once you have reviewed the above document please continue to section 2. 

Section 2 - Required Health Forms

Parents, please complete and return the following form(s) to the school Nurse before the start of the school year 2021 so we may update your student's health records:

  1. NSD Health Registration FormPDF downloadPDF download (English) (required for all students entering 6th grade)
    NSD Health Registration FormPDF downloadPDF download (Spanish) (Esto es requerido para todos los estudiantes que entran a 6th grado)

  2. CIS FormPDF downloadPDF download if your child has any immunization updates: a copy of a Health Care Provider record documenting vaccines given must be attached to this form or the HCP may sign and stamp the CIS form.

  3. Medication Authorization FormPDF downloadPDF download: Complete a Medication Authorization Form if your student will need medications to be given at school during school hours next year.

Once these forms have been completed and returned to Nurse Park you are all done. But please feel free to review the letter in Section 3 if you like.

Section 3 - Additional Information

Here is a letter from the District regarding Meningococcal and HPV Disease and Vaccines:

Meningiococcal/HPV Letter (This letter contains both English and Spanish