Wisconsin Immunization Program

Immunization Requirements

• Student Immunization Law Age/Grade Requirements for the 2008-2009 school years
  English / Spanish / Hmong (PDF, 32.0 KB)
• Varicella, Tdap, and PCV (Pneumococcal) School Requirements
• School Based Clinic Consent Forms Tdap and Varicella (PDF, 55.2 KB) - Tdap only (PDF, 26.5 KB)
• Letter to School Principals (PDF, 44.3 KB)
• School Fact Sheet for Parents
  English / Spanish / Hmong (PDF, 29.5 KB)
• Student Immunization Record (PDF, 46.2 KB)
• Student Immunization Record (Spanish) (PDF, 52.0 KB)
• Day Care Fact Sheet for Parents (PDF, 24.8 KB)
• Day Care Immunization Record (PDF, 20.1 KB)

• School Report to Local Health Department (PDF, 21.1 KB)
• School Report to the District Attorney (PDF, 9.5 KB)
• Chapter HFS 144 Immunization of Students (exit DHFS; PDF, 24.6 KB)
• Wisconsin Statute 252.04 (exit DHFS; PDF, 105.1 KB).
  The Immunization portion can be found on pg. 2 of the document.
• Chapter HFS 124 Hospitals (exit DHFS; PDF, 171.3 KB)
• History of Wisconsin Student Immunization Law

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Last Revised: April 22, 2008