P.O. BOX 2120



August 3, 2007



Division Superintendents



Billy K. Cannaday, Jr.

Superintendent of Public Instruction



New School Entrance Physical Examination Form (MCH 213F)


As the 2007-2008 school year begins, I want to take the opportunity to provide you with information regarding the new School Entrance Physical Examination Form (MCH 213F).


The Virginia Department of Health (VDH), in collaboration with the Virginia Chapter of the American Academy of Pediatrics (AAP), the Virginia Department of Education, and other stakeholders, has revised the school entrance physical exam form (MCH 213F). The form is used to document the physical examination required for entry into public kindergarten or elementary school, as required by the Code of Virginia at 22.1-270. The MCH 213F can be found at the following website:


The form is divided into three parts: Part I documents the childs health history, and is to be completed by the parent or other responsible adult; Part II certifies the students immunization status; and Part III documents the comprehensive physical exam. The immunization certification and the physical exam are to be completed by the attending physician, physician assistant or nurse practitioner.


The Recommendations to School section is the clinicians opportunity to summarize findings of note for school personnel receiving and reviewing the completed form. Specific areas include allergies, care plans needed, dietary needs, physical activity limitations or accommodations, and developmental status.


The intent of the school entry physical exam is to protect the public health and assist the school in preparing for the needs of the individual child. Therefore, Part I, Part II, and, at a minimum, the Recommendations to School section of Part III must be completed in full in order for the child to be admitted to school without delay.


Pursuant to the Code of Virginia at 22.1-270, students shall not be permitted to attend school without documentation of a comprehensive physical exam performed within the 12 months prior to the date the student enters public kindergarten or elementary school. The Code does not extend a grace period for complying with this regulation. Two exceptions exist to this requirement: homeless students and those whose parent objects due to religious belief. Homeless students are to be enrolled and immediately referred to the local school division homeless liaison for assistance in complying with entrance requirements. Parents objecting to a physical exam based upon religious belief must provide the school division with a written statement that the child is in good health and free from communicable or contagious disease.


Divisions may continue to accept physical examinations reported on the MCH 213E. If school divisions choose to make copies of the MCH 213F, the official color paper used by the VDH will be white.


Should you have further questions, please contact Tia Campbell, RN, BSN, NCSN, school health specialist, at 804-786-8671 or