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Health Forms

Self Carry / Self Administer

Parent/Guardian Form

Physician Form

Student Health History Form

Formulario de historial de salud del estudiante

Health and Wellness

District Wellness Policy

Cheyenne County School District Re-5 will implement a new Immunization Policy starting with the 2017-2018 school year.  Please click here for details.

Immunization Information

Click here for Child Care and Preschool Immunization Information

1.  Colorado will re-institute the Kindergarten entry and 6th grade entry immunizations for the 2016-2017 school year.

       - Students entering Kindergarten in the new school year will be required to have the final doses of:  DTaP (must be at least 4 yrs of age),  IPV (must be at least 4 years of age) as well as final doses of MMR and Varicella.

       - Students entering 6th grade will be required to have a dose of Tdap. (students who have received Tdap at an earlier age (minimum age to receive Tdap is 7 yrs) have already met this 6th grade Tdap requirement.)

2. Non-medical exemptions (religious and personal belief) will expire June 30th of every year. Non-medical exemptions (K through 12th grades) are to be submitted annually at each new school year.

Thank you,

Tracie Ball, RN


All medications (over-the-counter and prescription) must have a Doctor's prescription, except for cough drops and chapstick/lip balm.


District WellSAT Scorecard  (Click on date to view entire scorecard):

Date Total Compreshensiveness Total Strength
4/14/2015 50 14
10/6/2015 77 43
Change +27 +29