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b. A homeless child: A Homeless child, as defined in Florida Statute §1003.01.
c. Juvenile justice: A child who enters the juvenile justice system.
d. Military children: A military child as defined in the Interstate Compact on Educational
Opportunity for Military Children.

2017-2018 EXPLANATION OF PHYSICAL EXAMINATION REQUIREMENTS

STUDENTS PHYSICAL EXAMINATION
All SDPBC students School Health Entry Exam preferably on Form DH 3040* required for
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pre-K, Kindergarten, and 7 grade
All transfer students within the SDPBC Review of School Health Entry Exam preferably on Form DH 3040*
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and other counties within the State of (original or copy) for at least Kindergarten and/or 7 grade
Florida (including private schools) documentation
All transfer students from another School Health Entry Exam Form preferably on DH 3040* (original or
state or country copy) required for all grades. Physicals presented on forms from
another state are acceptable, if they include all components covered
on Form DH 3040* and have the physician’s signature and office
stamp. Physicals must have been performed within one year of
enrollment, unless exemption is based on a written request for
religious reasons.
*Form DH 3040 - State of Florida School Entry Health Exam Form

Required Immunization Form

The Florida Certification of Immunization Form (DH 680) is available from either private
physicians or the Florida Department of Health. The form includes sections for temporary and
permanent medical exemptions based on medical reasons. For example, all medical exemptions
must be signed by a physician (M.D. or D.O.), Temporary Medical Exemptions must have an
expiration date, and Permanent Medical Exemptions must specify which vaccine the student is
exempt from and the valid clinical reason for exemption.

The following DOH form must be completed, as applicable:
Immunization Form DH 680 or Florida SHOTS printed DH 680

The Certificate of Religious Exemption (DH 681) is available only through the Florida
Department of Health. Only an original DH 681, generated by The Florida SHOTS Program for
the Health Department, will be accepted at school sites.

NOTE: Homeless students and students entering a juvenile justice program without immunization and physical
exam documentation must be enrolled and receive a 30 school-day exemption. Follow-up with these students on
temporary exemptions is required prior to the expiration of the exemption.

SDPBC Student Progression Plan 2017-2018 Page 21