Health Business

Health Assessment Form

In accordance with Connecticut General statutes, each student enrolled in the Fairfield schools shall be required to have a health assessment by a legally qualified practitioner of medicine (physician or osteopath licensed to practice in the United States), or by an advanced practice registered nurse, registered nurse, or Physician Assistant licensed to practice in Connecticut.

  • Prior to initial entrance into preschool programs
  • Prior to initial entrance into kindergarten
  • For transfer students, prior to initial entrance into the Fairfield schools
  • In grades 6 and 9
  • For ungraded students, prior to initial entrance and whenever a health assessment is required for students of the same age cohort as the ungraded student.

In addition to all mandated screening/tests (indicated by an asterisk*), Health assessments shall include a TB risk assessment and, if indicated, a Mantoux tuberculin skin test.

Students participating in high school interscholastic sports (tryouts, practice, or play) shall be required to have a health assessment no more than thirteen months prior to participation in the sport for the current school year. The health assessment is valid for a period of thirteen months from the date it was done. Once the health assessment becomes more than thirteen-months old, the student cannot continue to participate in the sport until a new health assessment is done and submitted to the school.

Click on the link below to view the related PDF health information:

Dental Clinic Application Forms