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Thursday, May 24, 2012


        Kindergarten Round Up
                2012 – 2013
                School Registration Materials

Placer County CHDP is happy to provide forms and resources for use in your school registration process (Kindergarten and 1st Grade).  In addition to the required health examination forms and school immunization records, other useful information and resources are available at no cost to you.

Materials can either be downloaded here, or you may place an order with CHDP for printed materials. 

To place an order for printed materials, complete the Material Order Form and either fax to 530.886.3606 or email to
cjlang@placer.ca.gov.  Please allow 4 weeks for delivery.  Materials will be distributed to public schools through PCOE Interoffice Mail, or shipped via USP to private schools.

For question regarding Kindergarten Round Up, contact Cindi Lang at 530-886-3634 or
cjlang@placer.ca.gov.

Item #

Item (Revision date)

Language

Description

1

CHDP School Handbook

English

Booklet

2

Report of Health Examination for School Entry (PM171a 9/07) Required form.

Eng/Spa

2 sided

3

Waiver of Health Examination for School Entry (PM171b 9/07) Required form.

Eng/Spa

2 sided

4

Immunization Handbook (7th Edition July 2003) Contains school law info and materials to help implement.

English

Book

5

Placer County IZ Program Letter to Parents/IZ Clinic Schedule

English

2 sided

6

Placer County IZ Program Letter to Parents/IZ Clinic Schedule

Spanish

2 sided

7

Parent Guide to requirements of the California Immunization Law…. (IMM222 6/02)

Eng/Spa

2 sided

8

Immunization Record California School Blue Card (PM286 1/02) Required formOnly available by order

English

2 sided

9

Immunization Window (IMM-528 4/06)  Only available by order

English

mask

10

Placer County CHDP Program brochure

Eng/Spa

Tri-fold

11

Placer County CHDP Medical Provider list

Eng/Spa

List

12

Placer County CHDP Dental Provider list

Eng/Spa

List

13

Placer County CHDP Vision Provider list

Eng/Spa

List

14

Placer County Community Clinics Brochure

Eng/Spa

Tri-fold

15

California Health Care Programs/CAA list

Eng/Spa

2 sided

16

Little Changes, Big Rewards, flyer

Eng/Spa

2 sided



































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