Health Services

Roseville City School District

Medication Forms

Medications At School

A student who requires medication during the course of the school day must have written permission from both his/her parent or guardian and physician, detailing the medication, method of administration, amount, and time it is to be given.


Required For School Entry

Starting July 1, 2019, Students Admitted at TK/K-12 Need:

Diphtheria, Tetanus, and Pertussis (DTaP, DTP, Tdap, or Td) — 5 doses 
(4 doses OK if one was given on or after 4th birthday. 3 doses OK if one was given on or after 7th birthday.)
For 7th-12th graders, at least 1 dose of pertussis-containing vaccine is required on or after 7th birthday. 
Polio (OPV or IPV) — 4 doses 
(3 doses OK if one was given on or after 4th birthday) 
Hepatitis B — 3 doses 
(not required for 7th grade entry) 
Measles, Mumps, and Rubella (MMR) — 2 doses 
(Both given on or after 1st birthday) 
Varicella (Chickenpox) — 2 doses 

These immunization requirements also apply to students entering transitional kindergarten. 

California schools are required to check immunization records for all new student admissions at TK/Kindergarten through 12th grade and all students advancing to 7th grade before entry. Parents must show their child’s Immunization Record as proof of immunization. 


Family Life Resources

To view the video that will be shown in the Family Life Presentation, please click on the box to the right. Both the video and powerpoint are used during the presentations by the school nurses. A username and password are required to view the videos. You can find them on the permission slips.

Please click on the appropriate file below for your child’s grade to preview the Family Life materials.

4th Grade Girls Handout
4th Grade Girls Presentation

5th Grade GIRLS Presentation
5th Grade BOYS Presentation