•    Register

    ** CHILD MUST TURN FIVE YEARS OLD ON OR BEFORE DECEMBER 1, 2021 **

     

    Download and complete the forms below and bring to your appointment:

     

    PROOF OF IMMUNIZATION MUST BE PROVIDED AT TIME OF REGISTRATION

    immune

     
    • Diptheria, Pertussis, and Tetnus Vaccine (DTaP, DPT) 4-5 doses. One dose must be given after the 4th birthday
    • Polio Vaccine (IPV/OPV) 3-5 doses.  One dose must be given after the 4th birthday
    • Hepatitis B Vaccine 3 doses
    • Measles, Mumps, Rubella (MMR) 2 doses. First Dose on or after first birthday
    • Varicella Vaccine (or MD proof of disease) 2 doses. First dose on or after first birthday