Health Services

If your child is managing a chronic health condition, there may be additional health forms to help communicate how to support your child in the school setting. Below you’ll find consent forms for specific services.

• Administration of Medication Consent Form
• Asthma Action Plan
• Allergy and Anaphylaxis Action Plan
• Carry On Inhaler Contract
• Diabetes Medical Management Form
• G-Tube Physician Authorization
• Respiratory Disorders Physician Authorization
• Seizure Action Plan

Kentucky’s vaccine requirements for school entry, which is modeled after Centers for Disease Control and Prevention, include the following:

All students must have two doses of the Hepatitis A vaccine. The two doses of Hepatitis A vaccine must be given 6 months apart. Your child’s school nurse will need a certificate that indicates the two doses have been administered along with the date they were administered.

Students entering kindergarten must have a physical exam, a dental exam, an eye exam, and completed age appropriate immunizations. To see a list of immunization schedules please visit the Bardstown City Schools website under the parent tab or contact your pediatrician for more information.

Students going into sixth grade must have their immunizations updated and a physical exam. The physical form required by the state is different than the one required for sports physicals. Please use this Student Physical Exam Form.

All students who are 16 years or older are also required to have two doses of the Meningococcal ACWY vaccine. If the first dose of Meningococcal ACWY was received at age 16 or older, the second dose is not required for school entry.

Families can schedule an appointment for a physical or immunizations with their pediatrician’s office or at the Bardstown Healthy Kids Clinic. To make an appointment at the Bardstown Healthy Kids Clinic. For your child to receive services from the Healthy Kids Clinic you will need a registration form on file with our office. 

The Centers for Disease Control and Prevention (CDC) and Kentucky Department for Public Health (KDPH) recognize immunization as one of the most effective tools in preventing disease and reducing the risks associated with exposure to certain diseases. KRS 214.036 requires parents who object to immunization of their child to provide a written sworn statement objecting to immunization of the child on religious grounds. This Immunization Exemption Form will need to be completed and returned to your child’s school.

• Sports Physical (Grades 3-8)
• Sports Physical (Grades 9-12)

• Dental Screening Form
• Flu Vaccine Form
• Vision Exam Form
• Healthy Kids Dental Outreach Consent Form
• Covid-19 Vaccination Clinic Consent Form

For your child to receive services from the Healthy Kids Clinic you will need a registration form on file with our office. 

• Healthy Kids Clinic Registration Form
• Healthy Kids Clinic Vaccine Consent Form