P l e a s e R e t u r n t h i s S i g n e d F o r m t o t h e S c h o o l O f f i c e

Shots	Required	for

7th	Grade

Shots 4 Tots n Teens is a walk-in immunization clinic for children birth—18 years of age.
ALL INSURANCES ACCEPTED. Cash,
checks and credit cards accepted!
8 convenient locations!

L u c a s C o u n t y H e a l t h . c o m
O R  4 1 9 - 213 - 4 1 2 1

Parents are encouraged to make an appointment now with their child’s doctor or visit a Shots 4 Tots n Teens immunization clinic.

Ohio School Vaccination Requirements include a  Td ap  vaccine
booster shot and a  M e ning it is  shot for all children entering the
7th grade.

Please plan now to make sure that your child is up-to-date.
 Re quired  Vaccinations: 

Tdap Booster --protects against Tetanus, Diphtheria, and
Pertussis (Whooping Cough)

Meningitis Vaccine—(A,C,W,Y) Trade names
Menactra or Menveo. Potects against bacterial

Meningitis

Meningitis B IS NOT required for school

They are recommended to be given at age 11 –12 years.

Recommended Vaccinations:

•	HPV (Human Papillomavirus) — protects against cervical cancer in girls and genital warts in boys

I verify that this student  	

(name)

Has received Tdap vaccine on  	

(date)

Has received Meningitis vaccine on  	

(date)

Signed: 	

Must be signed by the medical professional. Forgery of a medical personnel is against the law and will be handled accordingly.