Pagosa Springs Elementary School

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Health Room Consent Form is a form to be signed by a parent or guardian stating the Health Room may give your child unscented lotion, Vaseline, etc...
Please sign and return if you give your child permission to receive the items listed on the form at school.
Required Shots for Kindergarten Entry
All incoming kindergarten students are required to have the following shots that have been given at the appropriate ages and intervals, documented on their shot record by the first day of school, September 3, 2019:
5 DTaP
4 Polio
3 Hepatitis B
2 MMR
2 Varicella (or documentation of the chicken pox disease)
These shots are available at:
San Juan Basin Public Health (970-264-2409)
Pagosa Springs Medical Center (970-731-3700)
Pagosa Medical Group (970-372-0456)
Axis (970-264-2104)
Walmart (970-731-9017)
City Market (970-731-6006)
If you would rather sign an exemption to decline these shots, please do so before the first day of school. Exemption forms will be in the front office at the school.
For questions, please contact Julie August, Health Clerk, at [email protected] or at 970-264-2256.
Downloads

These forms can be printed and completed by parents. Some of these forms need to be taken to doctor's appointments or filled out for the Health Aide to fax to your child's doctor. Some forms require a physician's and parent signature. For any questions, please contact the Health Room.