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School Health Services


School health services are an important component of the public health system and help assure that Florida’s students are healthy and ready to learn. Section (s.) 381.0056, Florida Statutes (F.S.), and Chapter 64-F, Florida Administrative Code (F.A.C), among others, provide the statutory authority and rules to plan, implement, and monitor school health services provided in Florida schools. School health services are intended to minimize health barriers to learning for public school students in grades prekindergarten through twelve in all 67 Florida counties. School health services include, but are not limited to, health appraisals, health screenings, nursing assessments, and referrals. These services help identify problems early and prevent the onset or worsening of chronic conditions that could impact students’ optimal development and the attainment of their educational goals.

Services are provided in accordance with a local school health services plan, s. 381.0056 (4)(a), F.S., and jointly developed by the county health department (CHD), school district, school health advisory committee (SHAC), and public/private partners. Health services are provided to public charter schools, based upon the charter, local contracts, and agreements. Counties offer school health services to private schools, based upon their participation in the school health services plan, and the availability of staff and local resources.

Florida Statutes and Rules related to School Health

Florida Department of Education School Health Partner

Health Issues - Guidelines, Resources and Training

Note: The following chronic conditions and selected links are provided based upon care management needs, statutory requirements and/or state prevalence. If information is desired on other conditions, please contact Student Support Services.

Records Resources

School Entry Health Exam

Florida law requires all students to meet the school entry health exam requirement. The School Entry Health Exam provides basic health and screening information that will assist the school and school health personnel in meeting the needs of the child. Florida law requires a school-entry health exam for all students who attend public and non-public schools in Florida.

Section 1003.22(1), F.S., mandates each county school district and the governing authority of each private school in Florida to require documentation of a school-entry health examination that was performed within one year of enrollment.

This Florida law includes a provision to allow a district school board or the governing authority of a private school to establish a policy that permits a student up to 30 school days to present a school-entry health examination. However, if the school district establishes such a policy, they must also include provisions in their local school health services plan to assist students with obtaining the required school-entry health examination. This section of statute also provides a 30-day exemption for children and youths who are experiencing homelessness, and includes a religious exemption provision upon written request of the parent.

Rule 6A-6.024, F.A.C., School Entry Health Examination, implements the school entry health exam required by s. 1003.22(1), F.S. and provides that any health professional who is licensed in Florida or the state where the student resided at the time of the health examination, and who is authorized to perform a general health examination under such licensure, shall be acceptable to certify that the health examination has been completed. Rule 6A-6.024, F.A.C., clarifies that certification that a health examination has been completed may be documented on the State of Florida, DH Form 3040-CHP-07/2013, “School Entry Health Exam.”

School Immunization Requirements

Florida law requires all students to meet grade-level immunization requirements.

Immunizations provide primary prevention to reduce morbidity and mortality from vaccine-preventable diseases in students and staff. High immunization rates increase the herd immunity of school populations in order to decrease the occurrence of vaccine-preventable diseases and to protect those at-risk because of age, immunodeficiency, or lack of vaccination. Each October, all public and private schools with a kindergarten or seventh-grade are required to submit reports that indicate the immunization status of their kindergarten and seventh-grade students.

Section 1003.22, F.S., specifies that each district school board and the governing authority of each private school shall establish and enforce policies that require before entering or attending a public or private school in Florida, in grades kindergarten through 12, or any other initial entrance, each child must provide or have on file with the immunization registry a certification of immunization for the prevention of those communicable diseases for which immunization is required by the Department of Health. Any child who is excluded from participation in the immunization registry pursuant to s. 381.003(1)(e)2., F.S. must present or have on file with the school such certification of immunization. Certification of immunization shall be made on forms approved and provided by the Department of Health (DH 680 form) or be on file with the immunization registry and shall become a part of each student’s permanent record, to be transferred when the student transfers, is promoted, or changes schools within the state. This section of statute includes provisions for exemptions from required immunizations, requires schools to submit annual reports of immunization compliance, and explains exclusion procedures.

For all students in grades PK-12, when DOE Code 2 is listed in Part B of the DH Form 680, it is a temporary exemption and it is imperative for school personnel to identify and track students with temporary medical exemptions to ensure that they complete their immunization series for protection from vaccine-preventable diseases. The student must return to the doctor or clinic before the expiration date to receive the required immunization(s). Subsection (10) of section 1003.22, F.S., stipulates that each district school board and the governing authority of each private school shall refuse admittance and temporarily exclude from attendance any student who in not in compliance with school immunization requirements.

Rule 64D-3.046, F.A.C., Immunization Requirement: Public and Nonpublic Schools, Grades Preschool, Kindergarten Through 12, and Adult Education Classes implements the school immunizations that are required by Florida law. Subsection (2) in 64D-3.046, F.A.C., explains the immunization and documentation requirements for student enrollment and attendance, including DH Forms 680 and 681. The required immunization compliance reporting by schools, including the use of DH Form 684 is described in 64D-3.046(3), F.A.C. Rule 64D-3.046(4), F.A.C., clarifies documentation of immunization exemptions for certain students and subsection (8) in Rule 64D-3.046, F.A.C., pertains to the authorization for schools and childcare facilities to directly access Florida SHOTS (State Health Online Tracking System).

For more information, contact:

Karla Bass, School Nurse Consultant
Student Support Services
Florida Department of Education
850-245-7851
Karla.Bass@fldoe.org