Forms

7th Grade Student Health Requirements

All new and continuing students must complete the following health requirements prior to attending 7th grade and pursuant to state law:


  • Physical examination (PE)

Must be completed within one (1) year before attending 7th grade.


  • Immunizations

Must meet the age, dose, and minimum intervals as described in the DOH Immunization Requirements Summary.

Students may be exempt from immunization requirements for medical or religious reasons.


  • Tuberculosis

If your child has been attending a Hawaii school, they do NOT need a new TB clearance at 7th grade.


It is important to plan ahead and schedule medical appointments before the new school year begins.


  • Bring the Student’s Health Record (Form 14) to your child’s medical appointment in order to document completion of the 7th grade health requirements.

  • Submit the completed Student's Health Record to your child’s school before the first day of class.

Hawaii Keiki Consent Form

Dear Parents/Guardians,

Did you know that Aiea Intermediate School has added a Nurse to your school health room to work with the School Health Assistant (SHA) in supporting your child’s health and education?

Aiea Intermediate School is staffed with a Hawai'i Keiki advanced practice registered nurse (APRN). When your child is sick at school, this APRN can treat your child and decide—if your child needs to go home or can stay in school.

The APRN can:

* Care for your child’s allergies, asthma, and other medical conditions.

* Give your child medication when needed.

* Offer advice about health topics to you and your children.

Why is this important? Because keeping your child in school keeps them in class, which keeps them learning.

This is a partnership between the University of Hawaii School of Nursing and the Department of Education. For more information see the Hawaii Keiki website.

There’s no cost to you for any services your child may receive. However, we need your insurance

information in case we need to bill them for certain services, but there will never be an out of pocket cost to the student or family.

Students without health insurance can still get care from the APRN at no cost.

But before a Hawai'i Keiki APRN can care for your child, we need your permission. Please review the enclosed consent form, sign it, and return it to Adeline Kline, APRN.

Remember that a Hawaii Keiki APRN doesn’t replace the care your child gets from the doctor or clinic. Also, even though you’ve signed the consent form, we won’t treat or give medications to your child without talking to a parent or guardian first.

If you have any questions about the consent form or the Hawai'i Keiki

APRN, please contact Adeline Kline at 808-861-6837

Thank you for keeping your child healthy and learning!

Acceptable Use Policy Form

The Hawaii State Department of Education (HIDOE) is committed to guiding students in their use of technology as a tool to support effective instruction and increase student achievement. HIDOE encourages the use ofHIDOE-owned or leased digital devices, network, and internet services for educational programs within the framework of these acceptable use guidelines. Parents and Guardians (hereafter collectively referred to as “Parent” or “Parents”) should review the guidelines with their child. Upon completion of reviewing the guidelines, both the Parent and the child should sign the attached Agreement form. The signed agreement form should be returned to the school so the student may begin using HIDOE-owned or leased devices.

EZSchoolPay

The new statewide student meal payment system provides the following online uses:

  • add funds securely, conveniently and directly into student meal accounts at any time from the app or online.

  • set recurring automatic payments to ensure accounts are always refilled.

  • receive automated alert notifications when the account balance drops below a certain amount.

  • view student meal transactions and account balances.

Click here for more information